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Underlying chronic condition increased mortality of infants with LOS
Infants hospitalized for late-onset sepsis, especially those with underlying chronic conditions, are at increased risk of mortality or morbidity, according to recent study findings.
“Fungemia became the significantly most serious pathogen causing [late-onset sepsis],” Yhu-Chering Huang, MD, PhD, of Chang Gung Memorial Hospital, and colleagues wrote in the study published in The Pediatric Infectious Disease Journal. “Besides, neonates with Psuedomonas [late-onset sepsis], fungemia, and underlying chronic conditions of congenital anomalies, neuromuscular sequelae, and secondary pulmonary hypertension with/without cor pulmonale were among independent predictors for final mortality.”
Yhu-Chering Huang
The cohort study included 5,010 neonates admitted to the neonatal ICU of Chang Gung Memorial Hospital in Taiwan, between Jan. 1, 2004 and Dec. 31, 2011.
Researchers found that 14.2% of participants experience 942 episodes of late-onset sepsis (LOS). There was a higher rate of infectious complication (30.8%), persistent bloodstream infection (19.2%), and sepsis-attributable mortality (23.1%) associated with fungemia. The overall mortality rate was 12.6%, while sepsis-attributable mortality rate was 7.2%. Pseudomonas LOS (OR=14.31; 95% CI, 3.87-53.0), fungemia (OR=5.69; 95% CI, 2.48-13.01), presence of congenital anomalies (OR=4.12; 95% CI, 1.60-10.60), neuromuscular comorbidities (OR=3.34; 95% CI, 1.66-6.73), and secondary pulmonary hypertension with/without cor pulmonale (OR=23.48; 95% CI, 5.96-92.49) were all independent predictors of in-hospital mortality.
“A substantial proportion of neonates hospitalized in neonatal ICUs would encounter late-onset sepsis,” Huang told Infectious Diseases in Children. “Fungi and Pseudomonas aeruginosa were the particular pathogens associated with poorer outcomes and underlying chronic conditions in these infants who were also at increased risk of mortality and morbidity.”
Disclosure: The researchers report no relevant financial disclosures.
