Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Volume 40, Issue 3, Pages 255-259Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0000000000002976
Keywords
neonatal sepsis; early onset; late onset; risk factors; outcome
Categories
Funding
- Ministerium fur Wissenschaft, Forschung und Kunst Baden-Wurttemberg
- European Social Fund
- German Ministry for Education and Research (BMBF) [01ER0805, 01ER1501]
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A study in Germany analyzed data from 14,926 preterm infants with birth weight <1500 g and found the rates of early-onset sepsis to be 1.1% and late-onset sepsis to be 11.9%. Multidisciplinary approaches are needed to reduce the burden of sepsis in VLBW infants.
Background: Sepsis is a major cause of death in neonates. Knowledge about epidemiology, risk factors, causative pathogens and outcome of neonatal sepsis is important to improve neonatal care. For Germany, only few data on neonatal sepsis in very low birth weight (VLBW) infants exist. Methods: Data from 14,926 preterm infants with birth weight <1500 g and gestational age between 22 0/7 weeks and 31 6/7 collected between January 2009 and December 2017 were analyzed for frequency of early-onset sepsis (EOS) and late-onset sepsis (LOS) and for causative pathogens. Risk factors for the development of EOS and LOS and outcomes after EOS and LOS were analyzed by multivariate logistic regression models. Results: EOS occurred in 1.1% of infants and LOS in 11.9%. Escherichia coli was the most common pathogen in EOS, coagulase-negative staphylococci in LOS. Multidrug-resistant organisms were detected in 8.4% of EOS and 3.9% of LOS cases. Risk factors for EOS were lower gestational age, intra-amniotic infection and spontaneous delivery. Risk factors for LOS were lower gestational age, small for gestational age, central lines, endotracheal ventilation and history of EOS. Both EOS and LOS were independently associated with adverse neonatal outcome. Conclusions: These data from a large German neonatal cohort confirm neonatal sepsis as the most common cause of morbidity and mortality in VLBW infants, as well as E. coli and coagulase-negative staphylococci as the most prevalent pathogens. Multidisciplinary approaches such as antibiotic stewardship, hygiene and feeding strategies are necessary to further reduce the burden of sepsis in VLBW infants.
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