Late-onset bloodstream infections in preterm infants: A 2-year survey

• Published in: Pediatrics international Vol. 54; no. 6; pp. 748 - 753
• Main Authors: Grisaru-Soen, Galia, Friedman, Tal, Dollberg, Shaul, Mishali, Hagit, Carmeli, Yehuda
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.12.2012; Blackwell Publishing Ltd
• Subjects: Age of Onset; Bacteremia - epidemiology; bloodstream infection; Circulatory system; Female; Follow-Up Studies; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - epidemiology; Infections; Intensive Care Units, Neonatal - statistics & numerical data; Israel - epidemiology; Klebsiella; Male; newborn; premature; Premature birth; Retrospective Studies; Risk Assessment - methods; Risk Factors; sepsis; Time Factors; Israel
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/j.1442-200X.2012.03679.x

Background:  We determined the prevalence and risk factors for late‐onset bloodstream infections (LO‐BSI), the distribution of pathogens and the outcomes of affected preterm infants. Methods:  The records of all preterm infants (<37 weeks gestation) born between 2004 and 2005 and hospitalized in the neonatal intensive care unit for >3 days were retrieved for this retrospective matched case–control study. Results:  A total of 108 out of 1459 preterm infants (7.4%) had 142 episodes of LO‐BSI. The highest LO‐BSI rate (44%) was among 198 very‐low‐birthweight infants (<1500 g). The most common causative organisms were Coagulase‐negative staphylococci and Klebsiella (60% and 13%, respectively). The mean hospital stay was 64 days for LO‐BSI preterm infants versus 48 days for non‐LO‐BSI preterm infants. Congenital malformations and peripheral catheters were independent risk factors for LO‐BSI. Crude mortality rates were 6.9% (LO‐BSI) and 3.0% (non‐LO‐BSI), with an LO‐BSI‐attributable mortality of 3.9%. Conclusion:  LO‐BSI frequently affect very‐low‐birthweight infants. Strategies to prevent LO‐BSI should target peripheral catheters.