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Early sepsis does not increase the risk of late sepsis in very low birth weight neonates.

Publication ,  Journal Article
Wynn, JL; Hansen, NI; Das, A; Cotten, CM; Goldberg, RN; Sánchez, PJ; Bell, EF; Van Meurs, KP; Carlo, WA; Laptook, AR; Higgins, RD; Stoll, BJ ...
Published in: J Pediatr
May 2013

OBJECTIVE: To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). STUDY DESIGN: Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through December 2009 who survived >72 hours and were cared for within the National Institute of Child Health and Human Development Neonatal Research Network. Sepsis was defined by growth of bacteria or fungi in a blood culture obtained ≤ 72 hours of birth (EOS) or >72 hours (LOS) and antimicrobial therapy for ≥ 5 days or death <5 days while receiving therapy. Regression models were used to assess risk of death or LOS by 120 days and LOS by 120 days among survivors to discharge or 120 days, adjusting for gestational age and other covariates. RESULTS: Of 34,396 infants studied, 504 (1.5%) had EOS. After adjustment, risk of death or LOS by 120 days did not differ overall for infants with EOS compared with those without EOS [risk ratio (RR): 0.99 (0.89-1.09)] but was reduced in infants born at <25 weeks gestation [RR: 0.87 (0.76-0.99), P = .048]. Among survivors, no difference in LOS risk was found overall for infants with versus without EOS [RR: 0.88 (0.75-1.02)], but LOS risk was reduced in infants with birth weight 401-750 g who had EOS [RR: 0.80 (0.64-0.99), P = .047]. CONCLUSIONS: Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2013

Volume

162

Issue

5

Start / End Page

942-8.e1-3

Location

United States

Related Subject Headings

  • Survival Analysis
  • Sepsis
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
 

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Wynn, J. L., Hansen, N. I., Das, A., Cotten, C. M., Goldberg, R. N., Sánchez, P. J., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2013). Early sepsis does not increase the risk of late sepsis in very low birth weight neonates. J Pediatr, 162(5), 942-8.e1-3. https://doi.org/10.1016/j.jpeds.2012.11.027
Wynn, James L., Nellie I. Hansen, Abhik Das, C Michael Cotten, Ronald N. Goldberg, Pablo J. Sánchez, Edward F. Bell, et al. “Early sepsis does not increase the risk of late sepsis in very low birth weight neonates.J Pediatr 162, no. 5 (May 2013): 942-8.e1-3. https://doi.org/10.1016/j.jpeds.2012.11.027.
Wynn JL, Hansen NI, Das A, Cotten CM, Goldberg RN, Sánchez PJ, et al. Early sepsis does not increase the risk of late sepsis in very low birth weight neonates. J Pediatr. 2013 May;162(5):942-8.e1-3.
Wynn, James L., et al. “Early sepsis does not increase the risk of late sepsis in very low birth weight neonates.J Pediatr, vol. 162, no. 5, May 2013, pp. 942-8.e1-3. Pubmed, doi:10.1016/j.jpeds.2012.11.027.
Wynn JL, Hansen NI, Das A, Cotten CM, Goldberg RN, Sánchez PJ, Bell EF, Van Meurs KP, Carlo WA, Laptook AR, Higgins RD, Benjamin DK, Stoll BJ, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early sepsis does not increase the risk of late sepsis in very low birth weight neonates. J Pediatr. 2013 May;162(5):942-8.e1–3.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2013

Volume

162

Issue

5

Start / End Page

942-8.e1-3

Location

United States

Related Subject Headings

  • Survival Analysis
  • Sepsis
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Male
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn