Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight
Objective: to establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. Method: this was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institut...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2014-01-01
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| Series: | Jornal de Pediatria |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755713001848 |
| _version_ | 1811302999640768512 |
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| author | Cláudia Regina Hentges Rita C. Silveira Renato Soibelmann Procianoy Clarissa Gutierrez Carvalho Gabriela Ribeiro Filipouski Rubia Nascimento Fuentefria Fernanda Marquezotti Ana Carolina Terrazan |
| author_facet | Cláudia Regina Hentges Rita C. Silveira Renato Soibelmann Procianoy Clarissa Gutierrez Carvalho Gabriela Ribeiro Filipouski Rubia Nascimento Fuentefria Fernanda Marquezotti Ana Carolina Terrazan |
| author_sort | Cláudia Regina Hentges |
| collection | DOAJ |
| description | Objective: to establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. Method: this was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II) at 18 to 24 months of corrected age. Results: 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p = 0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. Conclusion: neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit. Resumo: Objetivo: estabelecer a influência da sepse tardia no neurodesenvolvimento de prematuros de muito baixo peso (MBP) recém-nascidos (RNs) de acordo com o agente etiológico. Métodos: Coorte de RN com peso de nascimento < 1.500 ge idade gestacional < 32 semanas, internados na UTI da instituição dentro de 48 horas de vida, e atendidos no ambulatório de MBP para até dois anos de idade corrigida. Foram excluídos: a morte nas primeiras 72 h de vida, malformações congênitas e síndromes genéticas, filhos de mães HIV-positivas e infecção congênita, presença de sepse precoce, e os casos com mais de um microorganismo identificado em hemoculturas. RNs sépticos e não sépticos foram comparados quanto resultados neonatais, mortalidade e neurodesenvolvimento avaliadas através das escalas Bayley (BSDI-II) aos 18-24 meses de idade corrigida. Resultados: um total de 411 RNs prematuros de muito baixo peso eram elegíveis, com idade gestacional = 29 ± 2,2 semanas e peso de nascimento = 1.041 ± 281 g. Sepse tardia ocorreu em 94 casos (22,8%). MBP RN com infecção causada por microrganismos Gram-positivos apresentaram atraso motor, quando comparado com o grupo sem sépsis - 68,8% vs 29,3% (OR 6; 1,6-21,8, p = 0,006), e atraso cognitivo, foi semelhante. Taxa de mortalidade global de infecção foi de 26,7%, e as taxas de mortalidade por grupo microorganismo foram: Staphylococcus coagulase negativa, 18,7%; Gram-positivos, 21,8%; Gram-negativas e fungos, 50%. Conclusão: a sepse neonatal tem uma influência significativa no atraso no desenvolvimento neuropsicomotor aos dois anos de idade corrigida em prematuros de muito baixo peso RN e infecções Gram-positivas estão associadas com atraso motor. Keywords: Preterm, Neonatal sepsis, Mortality, Neurodevelopment, Very low birth weight, Palavras-chave: Prematuros, Muito baixo peso ao nascer, Sepse neonatal, Mortalidade, Neurodesenvolvimento |
| first_indexed | 2024-04-13T07:39:26Z |
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| id | doaj.art-ab1e7eb09e32420f922e1f79e9c388a4 |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-13T07:39:26Z |
| publishDate | 2014-01-01 |
| publisher | Elsevier |
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| series | Jornal de Pediatria |
| spelling | doaj.art-ab1e7eb09e32420f922e1f79e9c388a42022-12-22T02:55:57ZengElsevierJornal de Pediatria0021-75572014-01-019015057Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weightCláudia Regina Hentges0Rita C. Silveira1Renato Soibelmann Procianoy2Clarissa Gutierrez Carvalho3Gabriela Ribeiro Filipouski4Rubia Nascimento Fuentefria5Fernanda Marquezotti6Ana Carolina Terrazan7Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neonatology Service, Hospital de Clinícas de Porto Alegre, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neonatology Service, Hospital de Clinícas de Porto Alegre, Porto Alegre, RS, Brazil; Corresponding author.Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neonatology Service, Hospital de Clinícas de Porto Alegre, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Neonatology Service, Hospital de Clinícas de Porto Alegre, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilDepartment of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilObjective: to establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent. Method: this was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II) at 18 to 24 months of corrected age. Results: 411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p = 0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi. Conclusion: neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit. Resumo: Objetivo: estabelecer a influência da sepse tardia no neurodesenvolvimento de prematuros de muito baixo peso (MBP) recém-nascidos (RNs) de acordo com o agente etiológico. Métodos: Coorte de RN com peso de nascimento < 1.500 ge idade gestacional < 32 semanas, internados na UTI da instituição dentro de 48 horas de vida, e atendidos no ambulatório de MBP para até dois anos de idade corrigida. Foram excluídos: a morte nas primeiras 72 h de vida, malformações congênitas e síndromes genéticas, filhos de mães HIV-positivas e infecção congênita, presença de sepse precoce, e os casos com mais de um microorganismo identificado em hemoculturas. RNs sépticos e não sépticos foram comparados quanto resultados neonatais, mortalidade e neurodesenvolvimento avaliadas através das escalas Bayley (BSDI-II) aos 18-24 meses de idade corrigida. Resultados: um total de 411 RNs prematuros de muito baixo peso eram elegíveis, com idade gestacional = 29 ± 2,2 semanas e peso de nascimento = 1.041 ± 281 g. Sepse tardia ocorreu em 94 casos (22,8%). MBP RN com infecção causada por microrganismos Gram-positivos apresentaram atraso motor, quando comparado com o grupo sem sépsis - 68,8% vs 29,3% (OR 6; 1,6-21,8, p = 0,006), e atraso cognitivo, foi semelhante. Taxa de mortalidade global de infecção foi de 26,7%, e as taxas de mortalidade por grupo microorganismo foram: Staphylococcus coagulase negativa, 18,7%; Gram-positivos, 21,8%; Gram-negativas e fungos, 50%. Conclusão: a sepse neonatal tem uma influência significativa no atraso no desenvolvimento neuropsicomotor aos dois anos de idade corrigida em prematuros de muito baixo peso RN e infecções Gram-positivas estão associadas com atraso motor. Keywords: Preterm, Neonatal sepsis, Mortality, Neurodevelopment, Very low birth weight, Palavras-chave: Prematuros, Muito baixo peso ao nascer, Sepse neonatal, Mortalidade, Neurodesenvolvimentohttp://www.sciencedirect.com/science/article/pii/S0021755713001848 |
| spellingShingle | Cláudia Regina Hentges Rita C. Silveira Renato Soibelmann Procianoy Clarissa Gutierrez Carvalho Gabriela Ribeiro Filipouski Rubia Nascimento Fuentefria Fernanda Marquezotti Ana Carolina Terrazan Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight Jornal de Pediatria |
| title | Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| title_full | Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| title_fullStr | Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| title_full_unstemmed | Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| title_short | Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| title_sort | association of late onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight |
| url | http://www.sciencedirect.com/science/article/pii/S0021755713001848 |
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