NDLI: Risk factors for late onset gram-negative infections: a case-control study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Samanta, Srabani Farrer, Kate Breathnach, Aodhan Heath, Paul T.
Spatial Coverage	London
Description	Country affiliation: United kingdom Author Affiliation: Samanta S ( Division of Child Health, St George's, University of London, Cranmer Terrace, Tooting, London, UK.)
Abstract	OBJECTIVES: To determine the incidence, mortality and risk factors for neonatal late onset gram-negative sepsis and meningitis (LOGNS). DESIGN: Retrospective case-control study. SETTING: Tertiary neonatal unit in London. PATIENTS: Consecutive inborn infants with late onset (>48 h of life) invasive gram-negative infections diagnosed between 1999 and 2005. Controls were healthy infants matched for gestation and time of admission to the neonatal unit. MAIN OUTCOME MEASURES: Clinical and risk factor data. RESULTS: 73 cases of LOGNS were identified of which 48 were inborn and included in the study (incidence 1.85/1000 live births). Enterobacter spp. (28%), Escherichia coli (27%) and Klebsiella spp. (21%) were the most common pathogens. The majority of infants were of very low birthweight (VLBW; 79%), and cases and controls were well matched (median gestation 26 weeks). Overall case death was 27% in cases versus 13.5% in controls (p=0.08). There was no significant difference between cases and controls regarding maternal risk factors. Mechanical ventilation, total parenteral nutrition (TPN) and its duration, presence of a central venous line and its duration, use of specific antibiotics and the occurrence of necrotising enterocolitis at or before the first positive culture were all significantly associated with case status in univariate analysis. In multivariate logistic regression analysis, only duration of TPN at or before first positive blood culture remained independently associated with LOGNS (p<0.001). CONCLUSIONS: LOGNS occurs predominantly in VLBW infants. When the influence of gestational age is accounted for, the only independent risk factor found for late onset gram-negative neonatal infections is the duration of TPN.
File Format	HTM / HTML
ISSN	13592998
Issue Number	1
Volume Number	96
e-ISSN	14682052
Journal	Archives of Disease in Childhood - Fetal and Neonatal Edition
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2011-01-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pediatrics Discipline Perinatology Gram-negative Bacterial Infections Etiology Meningitis, Bacterial Sepsis Age Of Onset Birth Weight Epidemiologic Methods Female Gestational Age Epidemiology Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases Infant, Very Low Birth Weight London Male Parenteral Nutrition, Total Adverse Effects Journal Article
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health Obstetrics and Gynecology

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