Late-onset Neonatal Sepsis-A 10-year Review From North Queensland, Australia

被引:41
作者
Gowda, Harsha [1 ]
Norton, Robert [2 ]
White, Andrew [3 ]
Kandasamy, Yogavijayan [1 ]
机构
[1] Townsville Hosp, Dept Neonatol, 100 Angus Smith Dr, Douglas, Qld 4814, Australia
[2] Townsville Hosp, Dept Microbiol & Pathol, Douglas, Qld, Australia
[3] Townsville Hosp, Dept Pediat, Douglas, Qld, Australia
关键词
late-onset neonatal sepsis; neonates; coagulase-negative staphylococci; sepsis; BIRTH-WEIGHT INFANTS; INTENSIVE-CARE-UNIT; RESEARCH NETWORK; INFECTIONS; EPIDEMIOLOGY; RISK; SEPTICEMIA; EXPERIENCE; FEATURES; DISEASE;
D O I
10.1097/INF.0000000000001568
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: Late-onset sepsis (LOS) in neonates contributes significantly to both morbidity and mortality. To determine the incidence of LOS, risk factors for disease and the impact on subsequent hospital course, we evaluated a cohort of 6340 neonates admitted to the neonatal intensive care unit and of neonates (3-28 days) admitted from the community between January 2005 and January 2016. Methods: This was a retrospective case review of all neonates admitted with suspected LOS who had positive blood culture and/or cerebrospinal fluid cultures, for an organism determined to be a pathogen. Results: Of 6340 neonates who survived beyond 3 days, 2271 (35.8%) had 1 or more blood cultures collected for suspected LOS. Of these, 146 (6.4%) positive blood cultures were thought to represent true bacteremia. The vast majority of infections (73%) were caused by Gram-positive organisms, with coagulase-negative staphylococci accounting for 39.8% of infections. Lateonset neonatal sepsis occurred predominantly in the 24-28-week age group (75.9%) and in neonates who weighed less than 1000 g (73.6%). The incubation time for positive blood cultures for Gram-negative sepsis was less (13 hours) when compared with Gram-positive sepsis (20 hours). Thrombocytopenia, elevated C-reactive protein and chorioamnionitis were consistently associated with late-onset Gram-negative sepsis (P < 0.05). Eight neonates (6%) died secondary to LOS. Conclusions: LOS contributes significantly to mortality and morbidity in neonates and remains a challenge to clinicians. Necessary steps to reduce late-onset neonatal sepsis should be undertaken.
引用
收藏
页码:883 / 888
页数:6
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