Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates

Manzoni, Paolo; Maestri, Andrea; Leonessa, MariaLisa; Mostert, M.; Farina, Daniele; Gomirato, G

doi:10.1038/sj.jp.7211420

Cited by 68 publications

(56 citation statements)

References 27 publications

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“…It is possible that the small number of infants with fungemia in our cohort prevented detection of a real relationship between this condition and progression to severe ROP. However, it is also possible that fungal sepsis served as a non-specific marker for sustained severe illness in studies reporting an association between fungemia and ROP, [38][39][40][41] with cumulative illness severity adjusting for this risk in this study.…”

Section: Discussionmentioning

confidence: 94%

Cumulative illness severity and progression from moderate to severe retinopathy of prematurity

et al. 2007

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Objective: To test cumulative neonatal illness severity (IS) and IS fluctuation as predictors of progression from moderate to severe retinopathy of prematurity (ROP).Study Design: Data from research databases and medical record review were collected for infants from four neonatal intensive care unit (NICUs) admitted between 1995 and 2001 and diagnosed with prethreshold ROP. Cumulative neonatal IS measured using daily Scores for Neonatal Acute Physiology (SNAP) for the first 28 days of life, and IS fluctuation as assessed by summing changes between daily SNAP scores, were tested as predictors of progression to threshold ROP using logistic regression.Result: Infants progressing to threshold (n ¼ 79), compared to those not progressing to threshold (n ¼ 130), had significantly (P<0.05) lower gestational ages (25.2±1.1 versus 25.8±1.4 weeks), higher cumulative neonatal SNAP (255±77 versus 224±63 weeks) and had more severe hospitalizations as indicated by diagnoses and medical management. In regression analysis, gestational age, chronological age and presence of plus disease at first diagnosis of prethreshold were associated with development of threshold. After adjusting for these factors, cumulative neonatal SNAP was significantly associated with progression to threshold. However, addition of cumulative SNAP to the model only increased receiver-operating characteristic curve area from 0.77 to 0.78 (NS). Other factors, including SNAP fluctuation, were not associated with progression to threshold after adjustment using this model. Conclusion:Cumulative neonatal IS, as measured by cumulative SNAP, is an independent risk factor for progression from moderate to severe ROP. However, cumulative IS does not enhance assessment of risk for ROP progression after adjusting for simpler clinical factors.

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Section: Discussionmentioning

confidence: 94%

Cumulative illness severity and progression from moderate to severe retinopathy of prematurity

et al. 2007

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“…Finally, seven studies plus an abstract, all retrospective cohort studies, were found by both the authors and were included for analysis in this review. [12][13][14][15][16][17][18]20 The characteristics of these studies are presented in Table 1. There were many similarities and differences in the studies.…”

Section: Resultsmentioning

confidence: 99%

“…All patients included were only ELBW in some studies 12,[15][16][17][18]20 but VLBW and ELBW in others. 13,14 Also, all studies expressed their central tendency and measures of dispersion as mean ± standard deviation except one which expressed it as median and range. 18 In addition, all studies addressed the exposures of SFI alone except some that studied bacterial sepsis in addition to SFI 13,17 and others that studied the effect of race 16 on ROP.…”

Section: Resultsmentioning

confidence: 99%

“…13,14 Also, all studies expressed their central tendency and measures of dispersion as mean ± standard deviation except one which expressed it as median and range. 18 In addition, all studies addressed the exposures of SFI alone except some that studied bacterial sepsis in addition to SFI 13,17 and others that studied the effect of race 16 on ROP. The outcomes studied were ROP and threshold ROP in all except one that studied in addition to ROP, other short-term morbidity and long-term neurodevelopmental outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…[5][6][7] Neonatal candidemia occurs in 1.6 to 9% of VLBW infants 1,2 and 4 to 15% in extremely low birth weight infants (ELBW; birth weight <1000 g), with the 30-day mortality approaching 40%. 1,4,[8][9][10][11] The occurrence of candidemia has been reported as an independent risk factor associated with development of retinopathy of prematurity (ROP) [12][13][14][15][16][17] and ROP requiring laser surgery. 12 Yet others 18 have found such an association only in a univariate analysis but not in a multiple logistic regression model.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

Bharwani

Dhanireddy

2007

J Perinatol

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Objective: To study the association between systemic fungal infection (SFI) and the development of retinopathy of prematurity (ROP) and severe ROP in very low birth weight (VLBW) infants by systematic review and meta-analysis.Study Design: A meta-review was performed using a fixed effects model. The exposure and outcomes studied were SFI and all ROP/severe ROP, respectively in VLBW infants. Results and effect sizes analyzed with Review Manager 4.2 software are expressed as relative risk (RR), odds ratio (OR), risk difference (RD) and number needed to harm (NNH) with 95% confidence intervals.Result: Data for severe ROP were available from eight studies and on all ROP from seven of those eight studies. Estimated gestational age ranged from 24.7±1.6 to 28.6±4 weeks and birth weight from 673 (median) (range 426 to 995) to 1108 ± 266 g (mean ± s.d.). A total of 261 of 303 babies with SFI had all ROP vs 1081 of 1648 babies without SFI (OR 3.4*, 2.34-4.95) and 118 of 330 babies with SFI had severe ROP vs 235 of 1951 babies without SFI (OR 4.06*,). The NNH was 5.56* (4.54-7.14) for all ROP and 4.54* (3.70 to 5.88) for severe ROP (*P<0.00001).Conclusion: SFIs are associated with the development of all degrees of ROP and severe ROP in VLBW infants.

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Neonatal Bacteremia and Retinopathy of Prematurity

Tolsma¹

2011

Arch Ophthalmol

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To explore whether early or late and presumed or definite neonatal bacteremia are associated with an increased risk of severe retinopathy of prematurity (ROP). Methods:We evaluated 1059 infants born before week 28 of gestation for ROP. Infants were classified as having early (postnatal week 1) or late (weeks 2-4) definite (culture-proven) or presumed (antibiotics taken for Ͼ72 hours despite negative blood culture results) bacteremia. Severe ROP was defined as stage 3 to 5, zone 1, prethreshold/threshold, or plus disease. We used timeoriented risk models to adjust for confounders.Results: In univariable, but not multivariable, analysis, newborns with presumed early bacteremia were at increased risk for plus disease (odds ratio [OR], 1.7; 95% CI, 1.1-2.7), and those with definite early bacteremia were at increased risk for stage 3 to 5 disease (1.9; 1.1-3.2). Infants who had presumed or definite late bacteremia were at increased risk for all 4 indicators of severe ROP in univariable analysis. In multivariable analysis, newborns with presumed late bacteremia were at increased risk for prethreshold/threshold ROP (OR, 1.8; 95% CI, 1.02-3.2), and those with definite late bacteremia were at increased risk for prethreshold/threshold ROP (1.8; 1.1-2.9) and plus disease (1.8; 1.05-2.9).Conclusions: Definite late neonatal bacteremia seems to be an independent risk factor for prethreshold/threshold ROP and plus disease, and presumed late bacteremia seems to be related to prethreshold/threshold ROP.

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Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates

Cited by 68 publications

References 27 publications

Cumulative illness severity and progression from moderate to severe retinopathy of prematurity

Cumulative illness severity and progression from moderate to severe retinopathy of prematurity

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

Neonatal Bacteremia and Retinopathy of Prematurity

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