Background characteristics and outcomes in 5232 very preterm infants (<32 weeks’ gestation) without and with late-onset sepsis (LOS)
| Infants without LOS n=4457* | Culture-negative LOS n=282 | Culture-positive LOS n=493 | Gram-positive, excl. CoNS-LOS n=163 | CoNS LOS n=224 | Gram-negative LOS n=95 | Candida LOS n=11 | |
| Perinatal and neonatal data | |||||||
| Antenatal steroids (%) | 84.3 | 90.6 | 92.9 | 90.2 | 93.8 | 98.9 | 90.9 |
| Birth weight (g), median (IQR) | 1277 (980,1555) | 838 (652,1112) | 830 (676,1034) | 853 (697,1030) | 806 (658,1039) | 839 (700,1034) | 725 (635,856) |
| Small for gestational age (%) | 25.9 | 33.0 | 29.4 | 33.8 | 31.7 | 17.9 | 9.1 |
| Gestational age (weeks), median (IQR) | 29+6 (28+0, 31+1) | 26+6 (25+1, 28+6) | 26+4 (25+0, 28+2) | 26+4 (25+4, 28+6) | 26+4 (24+6, 28+1) | 26+5 (25+0, 28+1) | 24+5 (24+2, 26+1) |
| Caesarean delivery (%) | 51.1 | 56.0 | 44 | 50.3 | 43.8 | 36.8 | 27.3 |
| Female (%) | 45.6 | 40.8 | 41.6 | 41.2 | 41.5 | 44.2 | 27.3 |
| Apgar 5 min, median (IQR) | 8 (7, 9) | 7 (5, 8) | 7 (6, 8) | 7 (6, 8) | 7 (6, 8) | 7 (6, 8) | 6 (5, 8) |
| Mechanical ventilation days, median (IQR) | 0 (0,2) | 11 (2,33) | 11 (3,30.5) | 10 (2,31) | 12.5 (4,31) | 9 (3,23) | 36 (29,48) |
| Central catheters days, median (IQR) | 1.0 (0,1) | 15.0 (8,27) | 17.0 (10,26) | 15.0 (7,25) | 17.5 (12,28) | 16.0 (9,27) | 27.0 (18,53) |
| Parenteral nutrition days, median (IQR) | 3.0 (0,8) | 13.0 (7,21) | 13.0 (9,24) | 11 (7,19) | 15 (11,27) | 12 (8,20) | 20 (11,45) |
| Incidence LOS (%) | NA | 5.3 | 9.3 | 3.1 | 4.2 | 1.8 | 0.2 |
| Proportion CLABSI among LOS (%) | NA | NA | 41.6 | 25.8 | 51.8 | 42.1 | 72.7 |
| Outcomes | |||||||
| Day of life onset LOS, median (IQR) | NA | 27 (15,45) | 15 (9,28) | 25 (14,40) | 12 (8,21) | 13 (8,20) | 17 (10,32) |
| LOS-attributable mortality (%) | NA | 2.1 | 6.3 | 4.3 | 4.0 | 15.8 | 0 |
| Days to death from LOS onset, median (IQR) | NA | 4 (3,5) | 1 (1,2) | 1 (1,3) | 2 (1,2) | 2 (0,3) | NA |
| C reactive protein † (mg/L), median (IQR) | NA | 75 (48,138) | 53 (28,53) | 62 (35,110) | 46 (27,75) | 70 (26,131) | 47 (30,72) |
| Severe BPD (%) | 9 | 41.1 | 37.9 | 39.3 | 40.6 | 30.5 | 45.5 |
| Severe ROP (%) | 1.8 | 8.2 | 9.3 | 9.2 | 9.4 | 10.5 | 0 |
| Cystic PVL (%) | 2.3 | 3.2 | 7.3 | 8.6 | 5.4 | 10.5 | 9.1 |
| Severe ICH (%) | 3.4 | 8.2 | 9.7 | 7.4 | 8.4 | 14.7 | 16.7 |
| Surgically treated NEC (%) | 0.7 | 6.8 | 8.1 | 3.7 | 9.3 | 12.6 | 8.3 |
| Postnatal steroids (%) | 7.2 | 37.2 | 39.1 | 37.4 | 43.6 | 28.4 | 72.7 |
| Days of hospitalisation, median (IQR) | 46 (33, 66) | 89 (62,115) | 88 (61, 115) | 91 (61, 114) | 89 (67, 118) | 78 (48, 108) | 113 (92, 126) |
| PMA at discharge (weeks), median (IQR) | 36+4 (35+3, 38+1) | 39+4 (37+2, 42+2) | 39+2 (37+6, 41+6) | 39+2 (37+5, 39+2) | 39+3 (37+0, 42+2) | 38+2 (35+5, 41+3) | 40+3 (38+5, 43+0) |
LOS attributable mortality; defined as death within 7 days of positive blood culture or for culture neg. when blood culture was obtained divided by total affected infants. Severe bronchopulmonary dysplasia (BPD); need for any respiratory support, other than only O2, at 36+0 weeks postmenstrual age (PMA). Severe retinopathy of prematurity (ROP); receiving therapy with laser or antivascular endothelial growth factor. Cystic periventricular leukomalacia. Intracranial haemorrhage (ICH): grade 3–4 according to Papile. Central catheter days include any of the following: umbilical artery and/or vein, peripherally inserted central catheter and central venous catheter. Parenteral nutrition days; total days of parenteral nutrition, with or without lipids.
*64 infants with EOS, but without LOS, were excluded from this presentation/analysis.
†C reactive protein (CRP) maximum value; 211/775 (27%) of CRP values were missing. However, for all CoNS-LOS cases, the CRP value was traced and reported.
CLABSI, central line associated bloodstream infection; CoNS, coagulase-negative staphylococci; PVL, periventricular leukomalacia.