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Late-onset sepsis in very preterm infants in Norway in 2009-2018: a population-based study.
Huncikova, Zuzana; Vatne, Anlaug; Stensvold, Hans Jorgen; Lang, Astri Maria; Støen, Ragnhild; Brigtsen, Anne Karin; Salvesen, Bodil; Øymar, Knut Asbjørn Alexander; Rønnestad, Arild; Klingenberg, Claus.
Afiliación
  • Huncikova Z; Paediatric Department, Stavanger University Hospital, Stavanger, Norway.
  • Vatne A; Department of Clinical Science, University of Bergen, Bergen, Hordaland, Norway.
  • Stensvold HJ; Paediatric Department, Stavanger University Hospital, Stavanger, Norway.
  • Lang AM; Neonatal Department, Oslo University Hospital Rikshospitalet, Oslo, Norway.
  • Støen R; Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
  • Brigtsen AK; Paediatric Department, Akershus University Hospital, Lorenskog, Norway.
  • Salvesen B; Department of Paediatrics, St. Olav University Hospital, Trondheim, Norway.
  • Øymar KAA; Department of Neonatal Intensive Care, Oslo University Hospital Ullevaal, Oslo, Norway.
  • Rønnestad A; Department of Paediatrics and Adolescents Medicine, Haukeland University Hospital, Bergen, Norway.
  • Klingenberg C; Paediatric Department, Stavanger University Hospital, Stavanger, Norway.
Arch Dis Child Fetal Neonatal Ed ; 108(5): 478-484, 2023 Sep.
Article en En | MEDLINE | ID: mdl-36732047
OBJECTIVE: To evaluate epidemiology and outcomes among very preterm infants (<32 weeks' gestation) with culture-positive and culture-negative late-onset sepsis (LOS). DESIGN: Cohort study using a nationwide, population-based registry. SETTING: 21 neonatal units in Norway. PARTICIPANTS: All very preterm infants born 1 January 2009-31 December 2018 and admitted to a neonatal unit. MAIN OUTCOME MEASURES: Incidences, pathogen distribution, LOS-attributable mortality and associated morbidity at discharge. RESULTS: Among 5296 very preterm infants, we identified 582 culture-positive LOS episodes in 493 infants (incidence 9.3%) and 282 culture-negative LOS episodes in 282 infants (incidence 5.3%). Extremely preterm infants (<28 weeks' gestation) had highest incidences of culture-positive (21.6%) and culture-negative (11.1%) LOS. The major causative pathogens were coagulase-negative staphylococci (49%), Staphylococcus aureus (15%), group B streptococci (10%) and Escherichia coli (8%). We observed increased odds of severe bronchopulmonary dysplasia (BPD) associated with both culture-positive (adjusted OR (aOR) 1.7; 95% CI 1.3 to 2.2) and culture-negative (aOR 1.6; 95% CI 1.3 to 2.6) LOS. Only culture-positive LOS was associated with increased odds of cystic periventricular leukomalacia (cPVL) (aOR 2.2; 95% CI 1.4 to 3.4) and severe retinopathy of prematurity (ROP) (aOR 1.8; 95% CI 1.2 to 2.8). Culture-positive LOS-attributable mortality was 6.3%, higher in Gram-negative (15.8%) compared with Gram-positive (4.1%) LOS, p=0.009. Among extremely preterm infants, survival rates increased from 75.2% in 2009-2013 to 81.0% in 2014-2018, p=0.005. In the same period culture-positive LOS rates increased from 17.1% to 25.6%, p<0.001. CONCLUSIONS: LOS contributes to a significant burden of disease in very preterm infants and is associated with increased odds of severe BPD, cPVL and severe ROP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucomalacia Periventricular / Retinopatía de la Prematuridad / Displasia Broncopulmonar / Sepsis / Enfermedades del Prematuro Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Newborn Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Asunto de la revista: PEDIATRIA / PERINATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucomalacia Periventricular / Retinopatía de la Prematuridad / Displasia Broncopulmonar / Sepsis / Enfermedades del Prematuro Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Newborn Idioma: En Revista: Arch Dis Child Fetal Neonatal Ed Asunto de la revista: PEDIATRIA / PERINATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido