Late Onset Sepsis (LOS) in Infants < 1500 G Born in the Neocosur Neonatal Network Units

Autor: I Kurlat
Rok vydání: 2003
Předmět:
Zdroj: Pediatric Research. 53:870-870
ISSN: 1530-0447
0031-3998
DOI: 10.1203/00006450-200305000-00038
Popis: Introduction: Survival of very low birth weight (VLBW) infants has increased in the continent, being late onset sepsis (LOS) a frequent event. It has a major effect on neonatal morbidity (increased BPD, increased length of stay, neurologic sequelae, NEC) and mortality. There are multiple reports in the literature on the incidence and complications of LOS. However, few reveal the situation in Neonatal Intensive Care Units in Latin America. Objective: The present report analyzes the incidence of LOS in VLBW infants born in the period 01/2000 - 06/2002 within the NEOCOSUR Neonatal Network. It also considers the epidemiology of responsible microorganisms and the impact of LOS on outcome and mortality in this group of patients. Methods: The Network′s database (1359 neonates) was analyzed. It is permanently updated online, and it includes all VLBW infants born within the 18 participating units. This report includes data from the 1222 VLBW infants who survived for more than 72 hrs. Results: 390 neonates (32 %) had at least one LOS episode. The number of LOS episodes was inversely correlated with birth weight. The mean of days to the first LOS episode was 14.2 (median = 12; mode =7). For most infants the first episode of LOS was diagnosed between days 7 and 15. From all microorganisms isolated, 63 % were Gram +, 25 % were Gram -, and 12 % were Candida sp. These data are consistent with those reported by other Neonatal Research Networks (Israeli Neonatal Research Network and NICHD Neonatal Research Network in the USA). Overall, 15 % of VLBW neonates had LOS caused by S. Aureus. In some cases the same patient in one unit had multiple LOS episodes with the same bacteria over a prolonged period, thus pointing to the existence of a healthy carrier. Mortality was associated with LOS in 40 to 53 % of VLBW infants who died. Conclusions: LOS is a frequent event within the NEOCOSUR Neonatal Network and is strongly associated with the cause of death and increased morbidity of many of the babies. Controlling the incidence of LOS in the participating NEOCOSUR Units may lead to increased survival and a better quality of life for VLBW infants born within the system.
Databáze: OpenAIRE
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