Early-onset sepsis in very low birth weight neonates: A report from the National Institute of Child Health and Human Development Neonatal Research Network☆,☆☆,★,★★
Section snippets
Population database
The NICHD Neonatal Research Network is a consortium of tertiary academic neonatal centers. The Network maintains a registry of all VLBW infants born or cared for at participating centers. This registry was developed to describe the populations at each participating center, to survey neonatal practice, to assess morbidity and mortality rates, and to provide information for the planning of randomized clinical trials.10 Before 1993, infants with birth weights of 501 to 1500 gm were included in the
Incidence of infection and pathogen distribution
Seventy-eight hundred sixty-one VLBW neonates were admitted to network centers between May 1, 1991, and Dec. 31, 1993 (32 months). Two hundred fifty-five neonates, almost all of whom died in the first few hours of life, were not characterized for sepsis (i.e., blood not taken for culture) and were excluded from this analysis. The majority of these neonates were extremely low birth weight, were judged to be nonviable, and were provided with no or limited care (76% weighed ≤750 gm, 72% were born
DISCUSSION
Blood culture-proven early-onset sepsis was an uncommon event among VLBW neonates receiving neonatal intensive care at the 12 NICHD Neonatal Research Network centers. Only 1.9% of all infants weighing 401 to 1500 gm at birth who were characterized for early sepsis (i.e., had culture specimens taken) had a subsequent diagnosis of early-onset sepsis. There has been a marked increase in the intrapartum use of antibiotics in recent years. In this cohort, 31% of mothers received antibiotics before
Acknowledgements
We thank the research nurses of the NICHD Neonatal Research Network for careful data collection.
Members of the NICHD Neonatal Research Network are as follows: from Pennsylvania State University College of Medicine, Hershey: Ronald L. Poland, MD, Chairman; Case Western Reserve University, Cleveland, Ohio: Avroy A. Fanaroff, MB, BCh, Maureen Hack, MB, ChB, and Nancy Shenker Newman, RN; University of Cincinnati, Cincinnati, Ohio: Edward F. Donovan, MD, Reginald C. Tsang, MD, and Marcia Mersmann,
References (22)
- et al.
Early-onset coagulase-negative staphylococcal sepsis in the preterm neonate
Lancet
(1995) - et al.
Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 grams
J Pediatr
(1978) - et al.
Increased incidence of sepsis at birth in neutropenic infants of mothers with preeclampsia
J Pediatr
(1994) - et al.
Bacterial colonization of neonates admitted to an intensive care environment
J Pediatr
(1978) Evolution of microorganisms and antibiotic resistance
Lancet
(1984)- et al.
Bacterial sepsis and meningitis
- et al.
A half century of neonatal sepsis at Yale: 1928 to 1978
Arch Pediatr Adolesc Med [Am J Dis Child]
(1981) - et al.
Increasing incidence of neonatal septicemia: causative organism and predisposing risk factors
Acta Paediatr Scand
(1981) - et al.
Early and late neonatal septicaemia
Arch Dis Child
(1983) - et al.
Neonatal septicaemia
Arch Dis Child
(1985)
The changing face of neonatal infection: experience at a regional medical center
Pediatr Infect Dis J
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2022, Seminars in PerinatologyIncidence and microbiological characteristics of neonatal late onset sepsis in a neonatal intensive care unit in Peru
2021, International Journal of Infectious DiseasesCitation Excerpt :Table 3 shows a similar number of LOS caused by gram-positive and gram-negative microorganisms in our hospital. The most common organism causing LOS was CoNS in 38% of LOS episodes, similar to studies in different parts of the world (Bizzarro et al., 2005; Stoll et al., 1996; Gaynes et al., 1996; Rubin et al., 2002; Hammoud et al., 2017; Bizzarro et al., 2015; Stoll et al., 2002). These episodes are likely occurring due to the improvement in the survival of extremely premature infants.
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From Emory University, Atlanta, Georgia; George Washington University Biostatistics Center, Rockville, Maryland; University of Tennessee at Memphis; Wayne State University, Detroit, Michigan; University of Texas Southwestern Medical Center, Dallas; University of Miami, Miami, Florida; Case Western Reserve University, Cleveland, Ohio; Indiana University, Indianapolis; University of Cincinnati, Cincinnati, Ohio; Women and Infants Hospital, Providence, Rhode Island; Stanford University, Stanford, California; Yale University, New Haven, Connecticut; University of New Mexico, Albuquerque; and the National Institute of Child Health and Human Development, Bethesda, Maryland
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Supported by the National Institute of Child Health and Human Development through Cooperative Agreements: U10 HD21397, U10 HD27853, U10 HD27871, U10 HD21364, U10 HD21415, U10 HD27856, U10 HD27904, U10 HD27881, U10 HD21385, U10 HD27880, U10 HD27851, U10 HD21373, and U01 HD19897.
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Reprint requests: Barbara J. Stoll, MD, Emory University School of Medicine, Department of Pediatrics, 2040 Ridgewood Dr., Atlanta, GA 30322.
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0022-3476/96/$5.00 + 0 9/20/74003