Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study
IntroductionPurulent conjunctival discharge in hospitalized preterm infants may indicate conjunctivitis and warrant treatment. The purpose of this study was to examine the relationship between positive conjunctival swab (CS) culture and late-onset sepsis (LOS) in preterm infants.MethodsA retrospecti...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-11-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1259558/full |
| _version_ | 1797614208570884096 |
|---|---|
| author | Ashraf Gad Ashraf Gad Amr Khalil Muhammed Halil Prem Chandra Aly Soliman Abdel Rahman E’mar Marwa Ibrahim Fadi Al Khzzam Fadi Al Khzzam Talal AlHendawi Manal Hamed Mohammad A. A. Bayoumi Hawabibee Petkar |
| author_facet | Ashraf Gad Ashraf Gad Amr Khalil Muhammed Halil Prem Chandra Aly Soliman Abdel Rahman E’mar Marwa Ibrahim Fadi Al Khzzam Fadi Al Khzzam Talal AlHendawi Manal Hamed Mohammad A. A. Bayoumi Hawabibee Petkar |
| author_sort | Ashraf Gad |
| collection | DOAJ |
| description | IntroductionPurulent conjunctival discharge in hospitalized preterm infants may indicate conjunctivitis and warrant treatment. The purpose of this study was to examine the relationship between positive conjunctival swab (CS) culture and late-onset sepsis (LOS) in preterm infants.MethodsA retrospective cohort study was conducted to determine the relationship between positive CS culture growth results (CSP) obtained in preterm infants ≤34 weeks' gestation and the development of LOS within 120 h of obtaining CS compared with those who had negative CS culture results (CSN). Electronic medical records were reviewed from January 2015 until December 2019 for preterm infants presenting with purulent conjunctival discharge and underwent CS culture testing due to suspected conjunctivitis.ResultsOf the 234 CS cultures obtained during the study period, 145 (61.9%) were CSP compared to 89 (38.1%) CSN cultures. Gram-negative organisms accounted for 70% of all CSP cultures, with the remaining 30% being Gram-positive. Patients with CSP were smaller, younger, had lower 1-minute APGAR scores, and required respiratory support more frequently than those with CSN. Infants with CSP received antibiotics for longer periods, both topically and systemically. Infants who developed LOS were more likely to require invasive ventilation (adjusted odds ratio, 33.5; 95% CI, 2.52–446.5, p = 0.008). The incidence of LOS between the two groups was similar, with 6.2% observed in the CSP group compared to 3.4% in the CSN group (p = 0.543). Similarly, the rates of bacteremia were similar in both groups. Of the CSP patients who were presented with bacteremia, four out of seven (57%) exhibited bacteremia caused by the same organism found in their CS cultures. Similarly, within the entire cohort, respiratory cultures were performed on nine intubated patients within two weeks of obtaining CS cultures. Of these, in the CSP group, five out of six (83%) showed an organism identical to that found in the CS cultures.ConclusionThe study found a significant proportion of positive CS cultures in preterm infants, with distinct patient characteristics and treatment compared to negative cultures. While the incidence of LOS was not significantly different between the two groups, some CSP patients demonstrated bacteremia with the same CS organism, suggesting a possible connection between conjunctival or respiratory colonization and bacteremia. |
| first_indexed | 2024-03-11T07:06:32Z |
| format | Article |
| id | doaj.art-62f1ed7cc0ff4df594714669357ed2b3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T07:06:32Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-62f1ed7cc0ff4df594714669357ed2b32023-11-17T08:55:46ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-11-011110.3389/fped.2023.12595581259558Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort studyAshraf Gad0Ashraf Gad1Amr Khalil2Muhammed Halil3Prem Chandra4Aly Soliman5Abdel Rahman E’mar6Marwa Ibrahim7Fadi Al Khzzam8Fadi Al Khzzam9Talal AlHendawi10Manal Hamed11Mohammad A. A. Bayoumi12Hawabibee Petkar13Neonatal Intensive Care Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, QatarPediatric Department, Weill Cornell Medicine, Doha, QatarDivision of Neonatology, London Health Science, Western University, London, ON, CanadaNeonatal Intensive Care Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, QatarMedical Research Center, Hamad Medical Corporation, Doha, QatarDeparment of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, United StatesDepartment of Pediatrics, Cleveland Clinic Children’s, Cleveland, OH, United StatesDepartment of Pediatrics, Hamad Medical Corporation, Doha, QatarNeonatal Intensive Care Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, QatarPediatric Department, Weill Cornell Medicine, Doha, QatarDepartment of Pediatrics, Hamad Medical Corporation, Doha, QatarMicrobiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, QatarNeonatal Intensive Care Unit, Women’s Wellness and Research Center, Hamad Medical Corporation, Doha, QatarMicrobiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, QatarIntroductionPurulent conjunctival discharge in hospitalized preterm infants may indicate conjunctivitis and warrant treatment. The purpose of this study was to examine the relationship between positive conjunctival swab (CS) culture and late-onset sepsis (LOS) in preterm infants.MethodsA retrospective cohort study was conducted to determine the relationship between positive CS culture growth results (CSP) obtained in preterm infants ≤34 weeks' gestation and the development of LOS within 120 h of obtaining CS compared with those who had negative CS culture results (CSN). Electronic medical records were reviewed from January 2015 until December 2019 for preterm infants presenting with purulent conjunctival discharge and underwent CS culture testing due to suspected conjunctivitis.ResultsOf the 234 CS cultures obtained during the study period, 145 (61.9%) were CSP compared to 89 (38.1%) CSN cultures. Gram-negative organisms accounted for 70% of all CSP cultures, with the remaining 30% being Gram-positive. Patients with CSP were smaller, younger, had lower 1-minute APGAR scores, and required respiratory support more frequently than those with CSN. Infants with CSP received antibiotics for longer periods, both topically and systemically. Infants who developed LOS were more likely to require invasive ventilation (adjusted odds ratio, 33.5; 95% CI, 2.52–446.5, p = 0.008). The incidence of LOS between the two groups was similar, with 6.2% observed in the CSP group compared to 3.4% in the CSN group (p = 0.543). Similarly, the rates of bacteremia were similar in both groups. Of the CSP patients who were presented with bacteremia, four out of seven (57%) exhibited bacteremia caused by the same organism found in their CS cultures. Similarly, within the entire cohort, respiratory cultures were performed on nine intubated patients within two weeks of obtaining CS cultures. Of these, in the CSP group, five out of six (83%) showed an organism identical to that found in the CS cultures.ConclusionThe study found a significant proportion of positive CS cultures in preterm infants, with distinct patient characteristics and treatment compared to negative cultures. While the incidence of LOS was not significantly different between the two groups, some CSP patients demonstrated bacteremia with the same CS organism, suggesting a possible connection between conjunctival or respiratory colonization and bacteremia.https://www.frontiersin.org/articles/10.3389/fped.2023.1259558/fullneonatal sepsispretermneonatal bacteremiaconjunctivitisconjunctival swabconjunctival culture |
| spellingShingle | Ashraf Gad Ashraf Gad Amr Khalil Muhammed Halil Prem Chandra Aly Soliman Abdel Rahman E’mar Marwa Ibrahim Fadi Al Khzzam Fadi Al Khzzam Talal AlHendawi Manal Hamed Mohammad A. A. Bayoumi Hawabibee Petkar Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study Frontiers in Pediatrics neonatal sepsis preterm neonatal bacteremia conjunctivitis conjunctival swab conjunctival culture |
| title | Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study |
| title_full | Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study |
| title_fullStr | Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study |
| title_full_unstemmed | Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study |
| title_short | Preterm infants with positive conjunctival swab culture: risk factors and association with late-onset sepsis–a retrospective cohort study |
| title_sort | preterm infants with positive conjunctival swab culture risk factors and association with late onset sepsis a retrospective cohort study |
| topic | neonatal sepsis preterm neonatal bacteremia conjunctivitis conjunctival swab conjunctival culture |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1259558/full |
| work_keys_str_mv | AT ashrafgad preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT ashrafgad preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT amrkhalil preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT muhammedhalil preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT premchandra preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT alysoliman preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT abdelrahmanemar preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT marwaibrahim preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT fadialkhzzam preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT fadialkhzzam preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT talalalhendawi preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT manalhamed preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT mohammadaabayoumi preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy AT hawabibeepetkar preterminfantswithpositiveconjunctivalswabcultureriskfactorsandassociationwithlateonsetsepsisaretrospectivecohortstudy |