Early-onset sepsis linked to increased risk for morbidity, mortality in infants with low birth weight
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Early-onset sepsis led to an approximately threefold increased risk for death or major neurologic morbidities in infants with very low birth weight, findings from a study suggested.
Researchers in Israel performed a population-based observational study using data collected prospectively by the Israel Neonatal Network on all infants born with very low birth weight from 1995 to 2005. The goal of the study was to assess the mortality and major morbidities among this infant population.
The cohort included 15,839 infants with birth weights below the 10th percentile for gestational age according to the sex-specific growth charts of Kramer et al. The researchers defined early-onset sepsis clinically, and it required a positive blood culture obtained within the first 72 hours of life to confirm diagnosis. Early-onset sepsis was not diagnosed if cultures tested positive for organisms that were considered to be contaminants.
Three hundred eighty-three of the infants studied developed early-onset sepsis, with the most common pathogens being Escherichia coli (26.8%), coagulase-negative staphylococci (17.2%) and group B Streptococcus (9.4%). Additionally, gram-negative bacteria caused 55% of early-onset sepsis episodes, whereas gram-positive bacteria accounted for 42% and yeasts for 3%.
Results indicated that early-onset sepsis in very low birth weight infants was associated with an increased risk for mortality, according to the researchers, with most deaths occurring during the first six days of life.
The researchers also said that very low birth weight infants with early-onset sepsis were at higher risk for major neonatal morbidities, including severe intraventricular hemorrhage, severe retinopathy of prematurity and bronchopulmonary dysplasia. The researchers also reported that early-onset sepsis was associated with an overall increased risk for death and/or severe neurologic morbidity.
Although early-onset sepsis was noted in only 2.4% of the very low birth weight population born in Israel, it profoundly affected the outcome of these infants, the researchers wrote.
Klinger G. Pediatrics. 2010;125:e736-e740.
Kramer MS. Pediatrics. 2001;108:e35.