Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Special Feature
  • Published:

Executive summary of the workshop on infection in the high-risk infant

Abstract

For newborn infants in intensive care units, the morbidity and mortality from infection continues to be a major burden despite advances in neonatal care. Infants are at risk for early-onset, late-onset as well as hospital-acquired infections. Research studies are needed to optimize timely diagnosis and treatment, and develop patient-specific and system-wide strategies to prevent perinatal and neonatal infections. To address the knowledge gaps that preclude optimal, evidence-based care in this critical field, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) organized a workshop in August 2008. In this paper, we provide a summary of the discussions, focusing on major knowledge gaps, and prioritized suggestions for research in this area.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Stoll BJ, Hansen N, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al., for the NICHD Neonatal Research Network. Neurodevelopmental impairment among extremely low birth weight infants with neonatal infection. J AMA 2004; 292: 2357–2365.

    CAS  Google Scholar 

  2. Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR et al. Trends in neonatal morbidity and mortality for very low birth weight infants. Am J ObGyn 2007; 196 (2): 147.e1–147.e8.

    Google Scholar 

  3. Buhimschi CS, Bhandari V, Han YW, Dulay AT, Baumbusch MA, Madri JA et al. Using proteomics in perinatal and neonatal sepsis: hopes and challenges for the future. Curr Opin Infect Dis 2009; 22: 235–243.

    Article  CAS  Google Scholar 

  4. Escobar GJ, Fischer A, Li DK, Kremers R, Armstrong MA . Score for neonatal acute physiology: validation in three Kaiser Permanente neonatal intensive care units. Pediatrics 1995; 96: 918–922.

    CAS  Google Scholar 

  5. Escobar GJ, Li DK, Armstrong MA, Gardner MN, Folck BF, Verdi JE et al. Neonatal sepsis workups in infants ⩾2000 grams at birth: a population-based study. Pediatrics 2000; 106: 256–263.

    Article  CAS  Google Scholar 

  6. Arnon S, Litmanovitz I . Diagnostic tests in neonatal sepsis. Curr Opin Infect Dis 2008; 21: 223–227.

    Article  Google Scholar 

  7. Seybold U, Halvosa JS, White N, Voris V, Ray SM, Blumberg HM . Emergence of and risk factors for methicillin-resistant Staphylococcus aureus of community origin in intensive care nurseries. Pediatrics 2005; 122: 1039–1046.

    Article  Google Scholar 

  8. Huang YC, Chou YH, Su LH, Lien RI, Lin TY . Methicillin-resistant Staphylococcus aureus colonization and its association with infection among infants hospitalized in neonatal intensive care units. Pediatrics 2006; 118: 469–474.

    Article  Google Scholar 

  9. Healy CM, Hulten KG, Palazzi DL, Campbell JR, Baker CJ . Emergence of new strains of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Clin Infect Dis 2004; 39: 1460–1466.

    Article  Google Scholar 

  10. Whitley RJ, Monto AS . Prevention and treatment of influenza in high risk groups: children, pregnant women, immunocompromised hosts, and nursing home residents. J Infect Dis 2006; 194 (Supple 2): S133–S138.

    Article  Google Scholar 

  11. Goldenberg RL, Andrews WW, Goepfert AR, Faye-Petersen O, Cliver SP, Carlo WA et al. The Alabama preterm birth study: umbilical cord blood ureaplasma urealyticum and mycoplasma hominis cultures in very preterm newborn infants. Am J Obstet Gynecol 2008; 198: 43.e1–43.e5.

    Article  Google Scholar 

  12. Cohen B, Saiman L, Cimiotti J, Larsen E . Factors associated with hand hygiene practices in two neonatal intensive care units. Pediatr Infect Dis J 2003; 22: 494–499.

    PubMed  PubMed Central  Google Scholar 

  13. Won SP, Chou HC, Hsieh WS, Chen CY, Huang SM, Tsou KI et al. Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2004; 25: 742–746.

    Article  Google Scholar 

  14. Lam BC, Lee J, Lau YL . Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection. Pediatrics 2004; 114: e565–e571.

    Article  Google Scholar 

  15. Pessoa-Silva CL, Hugonnet S, Pfister R, Touveneau S, Dharan S, Posfay-Barbe K et al. Reduction of health care associated infection risk in neonates by successful hand hygiene promotion. Pediatrics 2007; 120: e382–e390.

    Article  Google Scholar 

  16. Hylander MA, Strobino DM, Dhanireddy R . Human milk feedings and infection among very low birth weight infants. Pediatrics 1998; 102: E38.

    Article  CAS  Google Scholar 

  17. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC, et al., NICHD Neonatal Research Network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118: e115–e123.

    Article  Google Scholar 

  18. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Higgins RD, Langer JC, et al., NICHD Neonatal Research Network. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120: e953–e959.

    Article  Google Scholar 

Download references

Acknowledgements

The following are the invited speakers: William W Andrews, PhD, MD, University of Alabama at Birmingham, Birmingham, Alabama; Carol J Baker, MD, Baylor College of Medicine, Houston, TX; Daniel K Benjamin, MD, MPH, PhD, Duke University, Durham, North Carolina; Reese H Clark, MD, Pediatrix Medical Group Center for Research & Education, Sunrise, FL; William H Edwards, MD, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Rosemary D Higgins, MD, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Jeanne A Jordan, MD, Magee Womens Research Institute, Pittsburg, PA; Joyce M Koenig, M.D., St Louis University School of Medicine, St Louis, MO; Stephen L Leib MD, Infectious Diseases Institute for Infectious Diseases University of Bern, Bern, Switzerland; Fernanda Lessa, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA; J Randall Moorman, MD, University of Virginia Health System, Charlottesville, VA; Srinivasa R Nagalla, MD, ProteoGenix Inc., Beaverton, OR; Josef Neu, MD, University of Florida, Gainesville, FL; Karen M. Puopolo, MD, MPH, Brigham and Women's Hospital, Boston, MA; Tonse NK Raju, MD, DCH, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; Lisa Saiman, MD, MPH, Columbia University, New York, New York; Michael P Sherman, MD, Southern Illinois University School of Medicine, Springfield, IL; Ann R Stark, MD, Baylor College of Medicine, Houston, TX; Barbara J Stoll, MD, Emory University School of Medicine, Atlanta, GA.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R D Higgins.

Ethics declarations

Competing interests

Dr Raju and myself are employees of the Federal Government. Dr Baker's travel to the meeting was covered by NICHD. We have no other conflicts to report.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Higgins, R., Baker, C. & Raju, T. Executive summary of the workshop on infection in the high-risk infant. J Perinatol 30, 379–383 (2010). https://doi.org/10.1038/jp.2009.199

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2009.199

Keywords

This article is cited by

Search

Quick links