Late-Onset Sepsis in Very Low Birth Weight Infants from Singleton and Multiple-Gestation Births - 23/05/13
, Barbara J. Stoll, MD 3, Jeffrey C. Murray, MD 1, C. Michael Cotten, MD, MHS 4, Seetha Shankaran, MD 5, Michele C. Walsh, MD, MS 6, Abbot R. Laptook, MD 7, Nancy S. Newman, RN 6, Ellen C. Hale, RN, BS, CCRC 3, Scott A. McDonald, BS 2, Abhik Das, PhD 8, Rosemary D. Higgins, MD 9Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Reprint requests: Edward F. Bell, MD, Department of Pediatrics, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242.Abstract |
Objectives |
To describe and compare the incidence of late-onset sepsis (LOS) and demographic and clinical characteristics associated with LOS in very low birth weight (VLBW) infants from singleton and multiple births, and to examine the heritability of susceptibility to LOS among VLBW twins by comparing same-sex and unlike-sex twin pairs.
Study design |
The study group comprised infants with birth weight 401-1500 g seen at clinical centers of the Eunice Kennedy Shriver National Institute of Child and Human Development Neonatal Research Network between 2002 and 2008. Only the first episode of LOS was included in our analysis. Stepwise logistic regression models were fitted separately for singleton and multiple pregnancies to examine the maternal and neonatal factors associated with LOS. LOS due solely to gram-negative bacteria in singleton and multiple pregnancies was also examined in separate models. The heritability of LOS was estimated by examining the concordance of LOS in twins from same-sex and unlike-sex pairs.
Results |
LOS occurred in 25.0% (3797 of 15
178) of singleton and 22.6% (1196 of 5294) of multiple-birth VLBW infants. Coagulase-negative staphylococci were the most common infecting organisms, accounting for 53.2% of all LOS episodes in singletons and 49.2% in multiples. Escherichia coli and Klebsiella species were the most commonly isolated gram-negative organisms, and Candida albicans was the most commonly isolated fungus. Concordance of LOS did not differ significantly between same-sex and unlike-sex twin pairs.
Conclusion |
LOS remains a common problem in VLBW infants. The incidence of LOS is similar for singleton and multiple-birth infants. The similar concordance of LOS in same-sex and unlike-sex twin pairs provides no evidence that susceptibility to LOS among VLBW infants is genetically determined.
Le texte complet de cet article est disponible en PDF.Keyword : LOS, NRN, SGA, VLBW
Plan
| Supported by grants from the National Institutes of Health (NIH) and the Eunice Kennedy Shriver National Institute of Child and Human Development (NICHD) for the Neonatal Research Network’s Generic Database and Follow-up Studies. Data collected at participating sites of the NICHD Neonatal Research Network were transmitted to RTI International, the data coordinating center for the network, which stored, managed, and analyzed the data for this study. R.H. is an employee of NIH and assisted with the study design, analysis, interpretation of data, writing of the report, and the decision to submit it for publication. The authors declare no conflicts of interest. |
Vol 162 - N° 6
P. 1120 - juin 2013 Retour au numéro
Article précédent
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