Early sepsis does not increase the risk of late sepsis in very low birth weight neonates

James L Wynn; Nellie I Hansen; Abhik Das; C Michael Cotten; Ronald N Goldberg; Pablo J Sánchez; Edward F Bell; Krisa P Van Meurs; Waldemar A Carlo; Abbot R Laptook; Rosemary D Higgins; Daniel K Benjamin Jr; Barbara J Stoll; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1016/j.jpeds.2012.11.027

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Early sepsis does not increase the risk of late sepsis in very low birth weight neonates

Journal article

Peer reviewed

Early sepsis does not increase the risk of late sepsis in very low birth weight neonates

James L Wynn, Nellie I Hansen, Abhik Das, C Michael Cotten, Ronald N Goldberg, Pablo J Sánchez, Edward F Bell, Krisa P Van Meurs, Waldemar A Carlo, Abbot R Laptook, …

The Journal of pediatrics, Vol.162(5), pp.942-948.e3

05/2013

DOI: 10.1016/j.jpeds.2012.11.027

PMCID: PMC3622770

PMID: 23295144

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Abstract

To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through December 2009 who survived >72 hours and were cared for within the National Institute of Child Health and Human Development Neonatal Research Network. Sepsis was defined by growth of bacteria or fungi in a blood culture obtained ≤ 72 hours of birth (EOS) or >72 hours (LOS) and antimicrobial therapy for ≥ 5 days or death <5 days while receiving therapy. Regression models were used to assess risk of death or LOS by 120 days and LOS by 120 days among survivors to discharge or 120 days, adjusting for gestational age and other covariates. Of 34,396 infants studied, 504 (1.5%) had EOS. After adjustment, risk of death or LOS by 120 days did not differ overall for infants with EOS compared with those without EOS [risk ratio (RR): 0.99 (0.89-1.09)] but was reduced in infants born at <25 weeks gestation [RR: 0.87 (0.76-0.99), P = .048]. Among survivors, no difference in LOS risk was found overall for infants with versus without EOS [RR: 0.88 (0.75-1.02)], but LOS risk was reduced in infants with birth weight 401-750 g who had EOS [RR: 0.80 (0.64-0.99), P = .047]. Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function.

Infant, Premature, Diseases - microbiology

Infant, Very Low Birth Weight

Humans

Risk Factors

Sepsis - epidemiology

Male

Infant, Premature, Diseases - mortality

Sepsis - mortality

Infant, Premature

Survival Analysis

Female

Retrospective Studies

Infant, Premature, Diseases - epidemiology

Infant, Newborn

Sepsis - microbiology

Details

Title: Subtitle: Early sepsis does not increase the risk of late sepsis in very low birth weight neonates
Creators: James L Wynn - Department of Pediatrics, Vanderbilt University, Nashville, TN, USA. james.wynn@vanderbilt.edu
Nellie I Hansen
Abhik Das
C Michael Cotten
Ronald N Goldberg
Pablo J Sánchez
Edward F Bell
Krisa P Van Meurs
Waldemar A Carlo
Abbot R Laptook
Rosemary D Higgins
Daniel K Benjamin Jr
Barbara J Stoll
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.162(5), pp.942-948.e3
DOI: 10.1016/j.jpeds.2012.11.027
PMID: 23295144
PMCID: PMC3622770
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Grant note: 1U10-HD45962-06 / NICHD NIH HHS U10 HD27856 / NICHD NIH HHS M01 RR997 / NCRR NIH HHS UL1 TR000041 / NCATS NIH HHS M01 RR16587 / NCRR NIH HHS NCRR UL1024160 / PHS HHS U10 HD53089 / NICHD NIH HHS U10 HD27880 / NICHD NIH HHS U10 HD27904 / NICHD NIH HHS M01 RR39 / NCRR NIH HHS M01 RR32 / NCRR NIH HHS M01 RR7122 / NCRR NIH HHS U10 HD27853 / NICHD NIH HHS M01 RR70 / NCRR NIH HHS U10 HD36790 / NICHD NIH HHS U10HD21415 / NICHD NIH HHS UL1 TR001449 / NCATS NIH HHS UL1 TR000454 / NCATS NIH HHS U10 HD40498 / NICHD NIH HHS M01 RR64 / NCRR NIH HHS M01 RR44 / NCRR NIH HHS UL1 RR24139 / NCRR NIH HHS U10 HD40492 / NICHD NIH HHS 8084 / PHS HHS U10 HD53119 / NICHD NIH HHS M01 RR80 / NCRR NIH HHS M01 RR59 / NCRR NIH HHS U10 HD34216 / NICHD NIH HHS HHSN267200700051C / NICHD NIH HHS U10 HD27851 / NICHD NIH HHS 1R01HD057956-02 / NICHD NIH HHS M01 RR125 / NCRR NIH HHS U10 HD53109 / NICHD NIH HHS U10 HD21397 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS HHSN275201000003I / NICHD NIH HHS U10 HD21364 / NICHD NIH HHS 1K24HD058735-01 / NICHD NIH HHS U10 HD053109 / NICHD NIH HHS U10 HD27871 / NICHD NIH HHS U10 HD40689 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD21385 / NICHD NIH HHS U10 HD40461 / NICHD NIH HHS M01 RR633 / NCRR NIH HHS M01 RR750 / NCRR NIH HHS U10 HD40521 / NICHD NIH HHS M01 RR6022 / NCRR NIH HHS U10 HD21373 / NICHD NIH HHS U10 HD27881 / NICHD NIH HHS 1R01FD003519-01 / FDA HHS M01 RR54 / NCRR NIH HHS U10 HD53124 / NICHD NIH HHS
Language: English
Date published: 05/2013
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093454102771

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