Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants

Neonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical a...

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Main Authors: Wai Ho Lim, Reyin Lien, Yhu-Chering Huang, Ming-Chou Chiang, Ren-Huei Fu, Shih-Ming Chu, Jen-Fu Hsu, Peng-Hong Yang
Format: Article
Language:English
Published: Elsevier 2012-08-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S187595721200068X
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author Wai Ho Lim
Reyin Lien
Yhu-Chering Huang
Ming-Chou Chiang
Ren-Huei Fu
Shih-Ming Chu
Jen-Fu Hsu
Peng-Hong Yang
author_facet Wai Ho Lim
Reyin Lien
Yhu-Chering Huang
Ming-Chou Chiang
Ren-Huei Fu
Shih-Ming Chu
Jen-Fu Hsu
Peng-Hong Yang
author_sort Wai Ho Lim
collection DOAJ
description Neonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical antibiotics coverage. Methods: This is a case series study performed by retrospective chart review of VLBW infants (birth body weight, BBW, <1500 g) in a medical center during a 5-year period from January 2005 to December 2009. Episodes of positive blood cultures, pathogen distribution and related clinical manifestations were described. Results: A total of 158 episodes of sepsis were identified from 1042 VLBW infants. Sepsis rate was 152 per 1000 live births. The vast majority of infections (60.7%) were caused by Gram-positive organisms [G(+)], and overall Coagulase-negative staphylococci (CoNS) (52.5%) were the most common pathogen identified. Prevalence for early-onset sepsis (EOS) was 1% and for late-onset sepsis (LOS) was 14.2%. Infants with EOS had a much higher case fatality rate than LOS (40% vs. 4.7%). Escherichia coli (40%) were the leading pathogen of EOS while CoNS (54.7%) was the leading pathogens of LOS. Overall, apnea and/or bradycardia and/or cyanosis (65.8%), poor activity (48.7%), and increased respiratory effort (43.0%) were the most common presenting features of sepsis. Conclusion: Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants.
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spelling doaj-art-292011d06f134a7f9644e0124308ca1c2025-08-20T02:00:43ZengElsevierPediatrics and Neonatology1875-95722012-08-0153422823410.1016/j.pedneo.2012.06.003Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight InfantsWai Ho Lim0Reyin Lien1Yhu-Chering Huang2Ming-Chou Chiang3Ren-Huei Fu4Shih-Ming Chu5Jen-Fu Hsu6Peng-Hong Yang7Division of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Pediatric Infectious Disease, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanDivision of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, TaiwanNeonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical antibiotics coverage. Methods: This is a case series study performed by retrospective chart review of VLBW infants (birth body weight, BBW, <1500 g) in a medical center during a 5-year period from January 2005 to December 2009. Episodes of positive blood cultures, pathogen distribution and related clinical manifestations were described. Results: A total of 158 episodes of sepsis were identified from 1042 VLBW infants. Sepsis rate was 152 per 1000 live births. The vast majority of infections (60.7%) were caused by Gram-positive organisms [G(+)], and overall Coagulase-negative staphylococci (CoNS) (52.5%) were the most common pathogen identified. Prevalence for early-onset sepsis (EOS) was 1% and for late-onset sepsis (LOS) was 14.2%. Infants with EOS had a much higher case fatality rate than LOS (40% vs. 4.7%). Escherichia coli (40%) were the leading pathogen of EOS while CoNS (54.7%) was the leading pathogens of LOS. Overall, apnea and/or bradycardia and/or cyanosis (65.8%), poor activity (48.7%), and increased respiratory effort (43.0%) were the most common presenting features of sepsis. Conclusion: Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants.http://www.sciencedirect.com/science/article/pii/S187595721200068Xneonatal intensive care unitsepsisvery-low-birth-weight infants
spellingShingle Wai Ho Lim
Reyin Lien
Yhu-Chering Huang
Ming-Chou Chiang
Ren-Huei Fu
Shih-Ming Chu
Jen-Fu Hsu
Peng-Hong Yang
Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
Pediatrics and Neonatology
neonatal intensive care unit
sepsis
very-low-birth-weight infants
title Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
title_full Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
title_fullStr Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
title_full_unstemmed Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
title_short Prevalence and Pathogen Distribution of Neonatal Sepsis Among Very-Low-Birth-Weight Infants
title_sort prevalence and pathogen distribution of neonatal sepsis among very low birth weight infants
topic neonatal intensive care unit
sepsis
very-low-birth-weight infants
url http://www.sciencedirect.com/science/article/pii/S187595721200068X
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