Journal article
Neurodevelopmental outcomes following neonatal late-onset sepsis and blood culture-negative conditions
Archives of disease in childhood. Fetal and neonatal edition, Vol.106(5), pp.467-473
09/2021
DOI: 10.1136/archdischild-2020-320664
PMCID: PMC8292446
PMID: 33478957
Abstract
ObjectiveDetermine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC).DesignRetrospective cohort study.Setting24 neonatal centres.PatientsInfants born 1/1/2006–31/12/2014, at 22–26 weeks gestation, with birth weight 401–1000 g and surviving >7 days were included. Infants with early-onset sepsis, necrotising enterocolitis, intestinal perforation or both LOS and LOCNC were excluded.ExposuresLOS and LOCNC were defined as antibiotic administration for ≥5 days with and without a positive blood/cerebrospinal fluid culture, respectively. Infants with these diagnoses were also compared with infants with neither condition.OutcomesDeath or NDI was assessed at 18–26 months corrected age follow-up. Modified Poisson regression models were used to estimate relative risks adjusting for covariates occurring ≤7 days of age.ResultsOf 7354 eligible infants, 3940 met inclusion criteria: 786 (20%) with LOS, 1601 (41%) with LOCNC and 1553 (39%) with neither. Infants with LOS had higher adjusted relative risk (95% CI) for death/NDI (1.14 (1.05 to 1.25)) and death before follow-up (1.71 (1.44 to 2.03)) than those with LOCNC. Among survivors, risk for NDI did not differ between the two groups (0.99 (0.86 to 1.13)) but was higher for LOCNC infants (1.17 (1.04 to 1.31)) compared with unaffected infants.ConclusionsInfants with LOS had higher risk of death, but not NDI, compared with infants with LOCNC. Surviving infants with LOCNC had higher risk of NDI compared with unaffected infants. Improving outcomes for infants with LOCNC requires study of the underlying conditions and the potential impact of antibiotic exposure.
Details
- Title: Subtitle
- Neurodevelopmental outcomes following neonatal late-onset sepsis and blood culture-negative conditions
- Creators
- Sagori Mukhopadhyay - Children's Hospital of PhiladelphiaKaren M Puopolo - Children's Hospital of PhiladelphiaNellie I Hansen - RTI InternationalScott A Lorch - Children's Hospital of PhiladelphiaSara B DeMauro - Children's Hospital of PhiladelphiaRachel G Greenberg - Duke UniversityC Michael Cotten - Duke UniversityPablo J Sanchez - Nationwide Children's HospitalEdward F Bell - University of IowaEric C Eichenwald - Children's Hospital of PhiladelphiaBarbara J Stoll - The University of Texas Health Science CenterNICHD Neonatal Res Network
- Resource Type
- Journal article
- Publication Details
- Archives of disease in childhood. Fetal and neonatal edition, Vol.106(5), pp.467-473
- DOI
- 10.1136/archdischild-2020-320664
- PMID
- 33478957
- PMCID
- PMC8292446
- NLM abbreviation
- Arch Dis Child Fetal Neonatal Ed
- ISSN
- 1359-2998
- eISSN
- 1468-2052
- Grant note
- DOI: 10.13039/100009633, name: Eunice Kennedy Shriver National Institute of Child Health and Human Development, award: K23HD088753, UG1 HD21364, M01 RR80, UG1 HD27904; DOI: 10.13039/100000009, name: Foundation for the National Institutes of Health, award: U10 HD21397, M01 RR16587, U10 HD27871, ULTR142, U10 HD36790, U10 HD40461, U10 HD40498, M01 RR7122, U10 HD53119, M01 RR54, UG1 HD21385, UG1 HD27851, M01 RR39, UG1 HD27853, M01 RR8084, UG1 HD27880, M01 RR70, UG1 HD34216, M01 RR32, UG1 HD40492, UL1 TR1117, M01 RR30, UL1 TR1111, UG1 HD40689, M01 RR633, UG1 HD53089, M01 RR997, UG1 HD53109, M01 RR59, UG1 HD68244, UG1 HD68263, U10 HD40521, M01 RR44, UL1 TR42, UG1 HD68270, UG1 HD68278, UG1 HD68284, UG1 HD87226, U10 HD53124, M01 RR64, UL1 RR25764, UG1 HD87229, U10 HD21373
- Language
- English
- Date published
- 09/2021
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353931302771
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