Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China
Objective: Studies about the epidemiology and risk factors of late onset of sepsis (LOS) in preterm very low birth weight (PVLBW) infants of developing countries are limited and variable. The objective of this study was to explore the epidemiology, risk factors and pathogens of LOS in VLBW infants i...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957221000905 |
| _version_ | 1818692686580809728 |
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| author | Liya Ma Qiongling Peng Wei Wang Yi Yang You Chen Liling Wang Hung-Chih Lin |
| author_facet | Liya Ma Qiongling Peng Wei Wang Yi Yang You Chen Liling Wang Hung-Chih Lin |
| author_sort | Liya Ma |
| collection | DOAJ |
| description | Objective: Studies about the epidemiology and risk factors of late onset of sepsis (LOS) in preterm very low birth weight (PVLBW) infants of developing countries are limited and variable. The objective of this study was to explore the epidemiology, risk factors and pathogens of LOS in VLBW infants in a Chinese tertiary hospital. Methods: Data concerning demographies, pathogens, risk factors and outcomes of LOS were collected in a cohort of 710 VLBW infants discharged from January 2012 to December 2018. Chi-square, t-test and multivariable logistic regression analysis were used to identify risk factors. Results: The overall incidence of LOS was 24.08% and blood culture-proven sepsis was 19.58%. Gram-negative bacteria accounted for 57.93%, and 32.41% of the isolates were Klebsiella pneumoniae. LOS led to a longer hospital stay, higher hospitalization cost and higher mortality compared to infants without LOS. Mortality in Gram-negative or fungi LOS was higher than in Gram-positive LOS. The factor of PVLBW infants with registered permanent residence (PR) was associated with 80% lower likelihood of LOS compared to those without registered PR (P = 0.000, 95% CI 0.096–0.420). Infants with thrombocytopenia had 2.5 times LOS of control (P = 0.014, CI 1.210–5.132). Duration of parenteral nutrition was a risk of LOS (P = 0.009, CI 1.010–1.069). Conclusion: Gram-negative bacteria, especially Klebsiella pneumonia, were the dominant pathogens in this study. Social factors might be a risk of LOS in PVLBW infants in developing countries. Taking measures to reduce the duration of parenteral nutrition may be helpful in decreasing the incidence of LOS. Awareness of thrombocytopenia may help to recognized diagnosis of LOS. |
| first_indexed | 2024-12-17T13:01:44Z |
| format | Article |
| id | doaj.art-ba60018186744206aa4d76bd3369b2d4 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-17T13:01:44Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-ba60018186744206aa4d76bd3369b2d42022-12-21T21:47:20ZengElsevierPediatrics and Neonatology1875-95722021-09-01625529535Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in ChinaLiya Ma0Qiongling Peng1Wei Wang2Yi Yang3You Chen4Liling Wang5Hung-Chih Lin6Department of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, ChinaDepartment of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, ChinaDepartment of Preventive Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, ChinaDepartment of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, ChinaDepartment of Neonatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, ChinaDepartment of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China; Corresponding author. No. 56 Yulv Road, Xin'an Street, Baoan District, Shenzhen, China.Department of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan; Asia University Hospital, Asia University, Taichung, Taiwan; Corresponding author. No.2 Yuh Der Road, Taichung, 404, Taiwan.Objective: Studies about the epidemiology and risk factors of late onset of sepsis (LOS) in preterm very low birth weight (PVLBW) infants of developing countries are limited and variable. The objective of this study was to explore the epidemiology, risk factors and pathogens of LOS in VLBW infants in a Chinese tertiary hospital. Methods: Data concerning demographies, pathogens, risk factors and outcomes of LOS were collected in a cohort of 710 VLBW infants discharged from January 2012 to December 2018. Chi-square, t-test and multivariable logistic regression analysis were used to identify risk factors. Results: The overall incidence of LOS was 24.08% and blood culture-proven sepsis was 19.58%. Gram-negative bacteria accounted for 57.93%, and 32.41% of the isolates were Klebsiella pneumoniae. LOS led to a longer hospital stay, higher hospitalization cost and higher mortality compared to infants without LOS. Mortality in Gram-negative or fungi LOS was higher than in Gram-positive LOS. The factor of PVLBW infants with registered permanent residence (PR) was associated with 80% lower likelihood of LOS compared to those without registered PR (P = 0.000, 95% CI 0.096–0.420). Infants with thrombocytopenia had 2.5 times LOS of control (P = 0.014, CI 1.210–5.132). Duration of parenteral nutrition was a risk of LOS (P = 0.009, CI 1.010–1.069). Conclusion: Gram-negative bacteria, especially Klebsiella pneumonia, were the dominant pathogens in this study. Social factors might be a risk of LOS in PVLBW infants in developing countries. Taking measures to reduce the duration of parenteral nutrition may be helpful in decreasing the incidence of LOS. Awareness of thrombocytopenia may help to recognized diagnosis of LOS.http://www.sciencedirect.com/science/article/pii/S1875957221000905gram-negative pathogenlate-onset sepsissocial factorsthrombocytopeniavery low birth weight infant |
| spellingShingle | Liya Ma Qiongling Peng Wei Wang Yi Yang You Chen Liling Wang Hung-Chih Lin Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China Pediatrics and Neonatology gram-negative pathogen late-onset sepsis social factors thrombocytopenia very low birth weight infant |
| title | Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China |
| title_full | Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China |
| title_fullStr | Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China |
| title_full_unstemmed | Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China |
| title_short | Late-onset sepsis in very low birth weight preterm infants: 7 years' experience at a tertiary hospital in China |
| title_sort | late onset sepsis in very low birth weight preterm infants 7 years experience at a tertiary hospital in china |
| topic | gram-negative pathogen late-onset sepsis social factors thrombocytopenia very low birth weight infant |
| url | http://www.sciencedirect.com/science/article/pii/S1875957221000905 |
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