A ten-year review of neonatal sepsis and comparison with the previous fifty-year experience

Gladstone, Igor M.; Ehrenkranz, Richard A.; Edberg, Stephen C.; Baltimore, Robert S.

doi:10.1097/00006454-199011000-00009

Cited by 269 publications

(164 citation statements)

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“…3,[6][7][8][9][10] The past decade's further implementation of neonatal intensive care facilities has led to increasing survival rates among preterm neonates. 11,12 Neonates are of younger gestational age and lower birth weight, and because of this they might be more seriously ill. Therefore, they may be more susceptible to HABSIs.…”

Section: Healthcare-associated Bloodstream Infection (Habsi) Is a Frementioning

confidence: 99%

Healthcare-Associated Bloodstream Infections in a Neonatal Intensive Care Unit over a 20-Year Period (1992–2011): Trends in Incidence, Pathogens, and Mortality

Verstraete

Boelens

Coen

et al. 2014

Infect. Control Hosp. Epidemiol.

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Objective.To analyze trends in the incidence and pathogen distribution of healthcare-associated bloodstream infections (HABSIs) over a 20-year period (1992–2011).Design.Historical cohort study.Setting.Thirty-two-bed neonatal intensive care unit (NICU) in a tertiary referral hospital.Patients.Neonates with HABSIs defined according to the criteria of the National Institute of Child Health and Development (NICHD).Methods.A hospital-based ongoing surveillance program was used to identify HABSI cases in neonates. A distinction between definite or possible HABSI was made according to the NICHD criteria. Incidence, incidence densities (HABSIs per 1,000 hospital-days and HABSIs per 1,000 total parenteral nutrition–days), and case fatality rate were calculated. Logistic regression analysis was used to find time trends. Four periods of 5 years were considered when executing variance analysis.Results.In total, 682 episodes of HABSIs occurred on 9,934 admissions (6.9%). The median total incidence density rate was 3.1 (interquartile range, 2.2–3.9). A significant increasing time trend in incidence density was observed for the period 1995–2011 (P < .003). A significant decrease in the case fatality rate was found in the last 5-year period (P < .001). No neonate died following possible HABSIs, whereas the case fatality rate among neonates with definite HABSIs was 9.7%. Most HABSIs were caused by coagulase-negative staphylococci (n = 414 [60.7%]). A significant increase in Staphylococcus aureus HABSI was observed in the last 10-year period (P < .001).Conclusions.An increase in incidence density rate occurred, while the case fatality rate dropped. Better perinatal care could be responsible for the latter. A decrease in days before infection and a high incidence of coagulase-negative Staphylococcus HABSIs indicate the need for vigorous application of evidence-based prevention initiatives, in particular for catheter care.

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Section: Healthcare-associated Bloodstream Infection (Habsi) Is a Frementioning

confidence: 99%

Healthcare-Associated Bloodstream Infections in a Neonatal Intensive Care Unit over a 20-Year Period (1992–2011): Trends in Incidence, Pathogens, and Mortality

Verstraete

Boelens

Coen

et al. 2014

Infect. Control Hosp. Epidemiol.

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“…As our ability to support the survival of smaller, less mature infants progressed, the variety of microorganisms with the potential to cause infection expanded to include more opportunistic infecting organisms and those that were not previously accepted as true potential pathogens, such as the coagulase-negative staphylococci (CONS). [1][2][3] From the 1960s through the 1990s, Streptococcus agalactiae, group B streptococcus (GBS), overtook S. aureus as the primary Gram-positive infecting organism. [4][5][6][7] Over the course of the following years, the list of not uncommon pathogens has continued to grow and be influenced by current medical practices and the pressures applied on these microorganisms from the rampant use of antimicrobials, including many broad-spectrum drugs that have contributed to the selection for multidrug-resistant organisms in and out of the hospital settings.…”

Section: Historical Perspectivesmentioning

confidence: 99%

The changing spectrum of neonatal infectious disease

Plano

2010

J Perinatol

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To understand the changing spectrum of neonatal infectious disease, one must first be familiar with the history, the variety of organisms and the progression of change of neonatal infections over the years. As progressively more immature neonates are surviving, the spectrum of infectious disease has changed in response to current medical practice responsible for this success and to selective pressures on the microorganisms. The surviving very low birth weight infants are at a significant risk for contracting infections from this expanding repertoire of pathogens. Microorganisms once thought seemingly benign and nonpathogenic are now commonly accepted as pathogens and are among the most likely organisms to cause infections in this extremely vulnerable patient population. When considering the possible identity of infecting organisms and attempting to tailor specific therapies to decrease unwanted consequences, one must consider the level of maturity and the age of neonate, as well as the intensity of care necessary for a successful outcome. This brief review focuses primarily on the changing spectrum of bacterial and fungal infections and will not substantially address viral infections.

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“…7 Escherichia coli is the second leading cause of EONS. 8 Neonatal symptoms in term neonates with E. coli or non-GBS EONS have not been well described. Despite the appearance of symptoms of sepsis within the first 24 hours of life in term neonates with GBS EONS, delaying treatment until symptoms develop may bring the risk of preventable morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

The Role of Intrapartum Fever in Identifying Asymptomatic Term Neonates With Early-Onset Neonatal Sepsis

et al. 2002

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A ten-year review of neonatal sepsis and comparison with the previous fifty-year experience

Cited by 269 publications

References 0 publications

Healthcare-Associated Bloodstream Infections in a Neonatal Intensive Care Unit over a 20-Year Period (1992–2011): Trends in Incidence, Pathogens, and Mortality

Healthcare-Associated Bloodstream Infections in a Neonatal Intensive Care Unit over a 20-Year Period (1992–2011): Trends in Incidence, Pathogens, and Mortality

The changing spectrum of neonatal infectious disease

The Role of Intrapartum Fever in Identifying Asymptomatic Term Neonates With Early-Onset Neonatal Sepsis

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