Jump to main content
US EPA
United States Environmental Protection Agency
Search
Search
Main menu
Environmental Topics
Laws & Regulations
About EPA
Health & Environmental Research Online (HERO)
Contact Us
Print
Feedback
Export to File
Search:
This record has one attached file:
Add More Files
Attach File(s):
Display Name for File*:
Save
Citation
Tags
HERO ID
3190459
Reference Type
Journal Article
Title
Incidence, clinical characteristics and risk factors for adverse outcome in neonates with late-onset sepsis
Author(s)
Tsai, MH; Hsu, JF; Chu, SM; Lien, R; Huang, HR; Chiang, MC; Fu, RH; Lee, CW; Huang, YC
Year
2014
Is Peer Reviewed?
1
Journal
Pediatric Infectious Disease Journal
ISSN:
0891-3668
EISSN:
1532-0987
Volume
33
Issue
1
Page Numbers
e7-e13
Language
English
PMID
23899966
DOI
10.1097/INF.0b013e3182a72ee0
Abstract
BACKGROUND:
Late-onset sepsis (LOS) is a common complication in the neonatal intensive care unit. We aimed to describe the epidemiology, clinical characteristics and risk factors for adverse outcome in neonates with LOS.
METHODS:
We conducted a cohort study of all neonates with LOS at the neonatal intensive care unit of a Tertiary Taiwan Medical Center from January 2004 through December 2011 and used multivariate logistic regression to identify risk factors for final adverse outcome.
RESULTS:
Among 5010 neonates over 253,644 neonate-days, 713 (14.2%) experienced a total of 942 episodes of LOS (incidence rate, 3.71 episodes per 1000 neonate-days). Although the rates of LOS were inversely proportional to birth weight and gestational age, the incidence rates were comparable among extremely preterm, late preterm and full term neonates. Fungemia was found to have significantly higher rate of infectious complication (30.8%), persistent bloodstream infection (19.2%) and sepsis attributable mortality (23.1%). The overall mortality rate was 12.6% (90/713), and sepsis attributable mortality rate was 7.2% (68/942 episodes). Independent predictors of in-hospital mortality were Pseudomonas LOS (adjusted odds ratio [OR], 14.31; 95% confidence interval [CI]: 3.87-53.0), fungemia (OR, 5.69; 95% CI: 2.48-13.01), presence of congenital anomalies (OR, 4.12; 95% CI: 1.60-10.60), neuromuscular comorbidities (OR, 3.34; 95% CI: 1.66-6.73) and secondary pulmonary hypertension with/without cor pulmonale (OR, 23.48; 95% CI: 5.96-92.49).
CONCLUSIONS:
LOS predisposes hospitalized neonates to increased risk of mortality or morbidity, especially caused by Pseudomonas aeruginosa or Candida spp. More aggressive treatment strategy is worth consideration in neonates with presumed LOS, particularly those with certain underlying chronic conditions.
Home
Learn about HERO
Using HERO
Search HERO
Projects in HERO
Risk Assessment
Transparency & Integrity