Cargando…
Patterns of Infections among Extremely Preterm Infants
Infections remain a leading cause of neonatal death, especially among the extremely preterm infants. To evaluate the incidence, pathogenesis, and in-hospital outcomes associated with sepsis among hospitalized extremely preterm infants born at 24–0/7 to 27–6/7 weeks of gestation, we designed a post h...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095151/ https://www.ncbi.nlm.nih.gov/pubmed/37048786 http://dx.doi.org/10.3390/jcm12072703 |
_version_ | 1785024014195884032 |
---|---|
author | Perez, Krystle Puia-Dumitrescu, Mihai Comstock, Bryan A. Wood, Thomas R. Mayock, Dennis E. Heagerty, Patrick J. Juul, Sandra E. |
author_facet | Perez, Krystle Puia-Dumitrescu, Mihai Comstock, Bryan A. Wood, Thomas R. Mayock, Dennis E. Heagerty, Patrick J. Juul, Sandra E. |
author_sort | Perez, Krystle |
collection | PubMed |
description | Infections remain a leading cause of neonatal death, especially among the extremely preterm infants. To evaluate the incidence, pathogenesis, and in-hospital outcomes associated with sepsis among hospitalized extremely preterm infants born at 24–0/7 to 27–6/7 weeks of gestation, we designed a post hoc analysis of data collected prospectively during the Preterm Epo Neuroprotection (PENUT) Trial, NCT #01378273. We analyzed culture positive infection data, as well as type and duration of antibiotic course and described their association with in-hospital morbidities and mortality. Of 936 included infants, 229 (24%) had at least one positive blood culture during their hospitalization. Early onset sepsis (EOS, ≤3 days after birth) occurred in 6% of the infants, with Coagulase negative Staphylococci (CoNS) and Escherichia Coli the most frequent pathogens. Late onset sepsis (LOS, >day 3) occurred in 20% of the infants. Nearly all infants were treated with antibiotics for presumed sepsis at least once during their hospitalization. The risk of confirmed or presumed EOS was lower with increasing birthweight. Confirmed EOS had no significant association with in-hospital outcomes or death while LOS was associated with increased risk of necrotizing enterocolitis and death. Extremely premature infants with presumed sepsis as compared to culture positive sepsis had lower rates of morbidities. In conclusion, the use of antibiotics for presumed sepsis remains much higher than confirmed infection rates. Ongoing work exploring antibiotic stewardship and presumed, culture-negative sepsis in extremely preterm infants is needed. |
format | Online Article Text |
id | pubmed-10095151 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100951512023-04-13 Patterns of Infections among Extremely Preterm Infants Perez, Krystle Puia-Dumitrescu, Mihai Comstock, Bryan A. Wood, Thomas R. Mayock, Dennis E. Heagerty, Patrick J. Juul, Sandra E. J Clin Med Article Infections remain a leading cause of neonatal death, especially among the extremely preterm infants. To evaluate the incidence, pathogenesis, and in-hospital outcomes associated with sepsis among hospitalized extremely preterm infants born at 24–0/7 to 27–6/7 weeks of gestation, we designed a post hoc analysis of data collected prospectively during the Preterm Epo Neuroprotection (PENUT) Trial, NCT #01378273. We analyzed culture positive infection data, as well as type and duration of antibiotic course and described their association with in-hospital morbidities and mortality. Of 936 included infants, 229 (24%) had at least one positive blood culture during their hospitalization. Early onset sepsis (EOS, ≤3 days after birth) occurred in 6% of the infants, with Coagulase negative Staphylococci (CoNS) and Escherichia Coli the most frequent pathogens. Late onset sepsis (LOS, >day 3) occurred in 20% of the infants. Nearly all infants were treated with antibiotics for presumed sepsis at least once during their hospitalization. The risk of confirmed or presumed EOS was lower with increasing birthweight. Confirmed EOS had no significant association with in-hospital outcomes or death while LOS was associated with increased risk of necrotizing enterocolitis and death. Extremely premature infants with presumed sepsis as compared to culture positive sepsis had lower rates of morbidities. In conclusion, the use of antibiotics for presumed sepsis remains much higher than confirmed infection rates. Ongoing work exploring antibiotic stewardship and presumed, culture-negative sepsis in extremely preterm infants is needed. MDPI 2023-04-04 /pmc/articles/PMC10095151/ /pubmed/37048786 http://dx.doi.org/10.3390/jcm12072703 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Perez, Krystle Puia-Dumitrescu, Mihai Comstock, Bryan A. Wood, Thomas R. Mayock, Dennis E. Heagerty, Patrick J. Juul, Sandra E. Patterns of Infections among Extremely Preterm Infants |
title | Patterns of Infections among Extremely Preterm Infants |
title_full | Patterns of Infections among Extremely Preterm Infants |
title_fullStr | Patterns of Infections among Extremely Preterm Infants |
title_full_unstemmed | Patterns of Infections among Extremely Preterm Infants |
title_short | Patterns of Infections among Extremely Preterm Infants |
title_sort | patterns of infections among extremely preterm infants |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095151/ https://www.ncbi.nlm.nih.gov/pubmed/37048786 http://dx.doi.org/10.3390/jcm12072703 |
work_keys_str_mv | AT perezkrystle patternsofinfectionsamongextremelypreterminfants AT puiadumitrescumihai patternsofinfectionsamongextremelypreterminfants AT comstockbryana patternsofinfectionsamongextremelypreterminfants AT woodthomasr patternsofinfectionsamongextremelypreterminfants AT mayockdennise patternsofinfectionsamongextremelypreterminfants AT heagertypatrickj patternsofinfectionsamongextremelypreterminfants AT juulsandrae patternsofinfectionsamongextremelypreterminfants AT patternsofinfectionsamongextremelypreterminfants |