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Title: Late-onset Bloodstream Infections in Hospitalized Term Infants
Authors: Testoni, Daniela [UNIFESP]
Hayashi, Madoka
Cohen-Wolkowiez, Michael
Benjamin, Daniel K.
Lopes, Renato D.
Clark, Reese H.
Smith, P. Brian
Duke Clin Res Inst
Universidade Federal de São Paulo (UNIFESP)
Duke Univ
Pediat Obstet Ctr Res & Educ
Clemson Univ
Keywords: sepsis
term birth
Issue Date: 1-Sep-2014
Publisher: Lippincott Williams & Wilkins
Citation: Pediatric Infectious Disease Journal. Philadelphia: Lippincott Williams & Wilkins, v. 33, n. 9, p. 920-923, 2014.
Abstract: Background: the epidemiology and incidence of late-onset blood stream infections (BSIs) in premature infants have been described, but studies describing late-onset BSI in term infants are sparse. We sought to describe the pathogens, incidence, risk factors and mortality of late-onset BSI in hospitalized term infants.Methods: A cohort study was conducted of infants >= 37 weeks gestational age and <= 120 days of age discharged from Pediatrix Medical Group neonatal intensive care units from 1997 to 2010. We examined all cultures obtained from day of life 4-120 and used multivariable regression to assess risk factors for late-onset BSI.Results: We found a total of 206,019 infants cared for between day of life 4 and 120, and the incidence of late-onset BSI was 2.7/1000 admissions. We identified Gram-positive organisms in 64% of the cultures and -Gram-negative organisms in 26%. We found a decreased risk of late-onset BSI in infants with the following characteristics: small for gestational age, delivery by Cesarean, antenatal antibiotic use and discharged in the later years of the study. Late-onset BSI increased the risk of death after controlling for confounders [odds ratio 8.43 (95% confidence interval 4.42-16.07)].Conclusion: Our data highlight the importance of late-onset BSI in hospitalized term infants. We identified Gram-positive organisms as the most common pathogen, and late-onset BSI was an independent risk factor for death.
ISSN: 0891-3668
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