Abstract
Background: Nosocomial infection is a very frequent event among small preterm infants. Its occurrence increases neonatal morbidity and mortality. A better understanding of the associated variables could contribute to reduce the infection rate.
Objective: To determine factors independently associated with nosocomial sepsis in preterm infants with birth weight < 1250 grams.
Design/methods: Cohort study. We assessed all preterm infants < 1250 grams born in our institution between January 1st, 1993 and December 31st 2003. Infants who died within the first 3 days of life and those with congenital infections or major malformations were not considered for inclusion. A multiple regression analysis was performed considering presence of proven bacterial sepsis (positive blood or CSF culture) as dependent variable, and gestational age, respiratory distress syndrome (RDS), surfactant administration, patent ductus arteriosus, length of mechanical ventilation (MV), parenteral nutrition and indwelling catheters, as independent variables.
Results: During the study period, 191 infants < 1250 g were born in our Hospital. We excluded 21 infants who died within the first 72 hours after birth, one with a complex cardiac anomaly, and five because of missing data, thus 164 infants were included for analysis. Mean birth weight was 939 grams, and mean gestational age, 28 weeks. Overall mortality was 24.2%. The rate of small for gestational age was 29%. Sixty two patients had proven bacterial sepsis (38%). The regression analysis showed the following variables as significatively associated with sepsis: RDS (OR = 3.9 CI 95%: 1.07- 14.6), length of MV (OR = 1.02 CI 95%: 1.00 - 1.03) and days on parenteral nutrition (OR = 1.07 CI 95%: 1.03 - 1.11). Increasing gestational age (OR 0.88 CI95%: 0.73-1.05) and the administration of surfactant (OR = 0.26 CI 95%: 0.07 - 0.92) were associated with a lower incidence of sepsis.
Conclusions: In our cohort of preterm infants < 1250 grams, the risk of nosocomial sepsis was increased by the presence of RDS, days on parenteral nutrition and length of MV. Surfactant administration seems to have a protective effect.
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Pardo, A., Cravedi, V., Mariani, G. et al. 13 Factors Associated with Nosocomial Infection in Preterm Infants < 1250 Grams. Pediatr Res 57, 922 (2005). https://doi.org/10.1203/00006450-200506000-00041
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DOI: https://doi.org/10.1203/00006450-200506000-00041