Clinical and Laboratory Factors That Predict Death in Very Low Birth Weight Infants Presenting With Late-onset Sepsis

Levit, Orly; Bhandari, Vineet; Li, Fangyong; Shabanova, Veronika; Gallagher, Patrick G.; Bizzarro, Matthew J.

doi:10.1097/inf.0000000000000024

Cited by 53 publications

(54 citation statements)

References 21 publications

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“…Other investigations have identified risk factors for developing fatal sepsis during the birth hospitalization for premature infants. These studies focused on static infant and maternal associations at birth (gender, maternal age, 5-minute Apgar score 4 ) and at the onset of sepsis (vasopressors and thrombocytopenia 14 ). Our analysis of the dynamics of sepsis-associated organ dysfunction among hospitalized infants over the days preceding death adds another dimension to our understanding of the pathophysiologic response to sepsis in this population.…”

Section: Discussionmentioning

confidence: 99%

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

et al. 2016

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Objective Identify the progression of specific signs of multi-organ dysfunction among infants with fatal sepsis. Study design Cohort study of 679 infants who died within 3 days of the start of a late-onset sepsis (LOS) episode in neonatal intensive care units from 1997–2012. We extracted clinical and laboratory data on the day of death (day 0) and the preceding 5 days (days −5 to −1). Results Median (25th percentile-75th percentile) gestational age was 25 (24–28) weeks. Compared with day −1, day 0 was characterized by an increased requirement for mechanical ventilation and higher mean fraction of inspired oxygen. Measures of cardiorespiratory support and the proportion of infants with neutropenia began to rise on day −2. Conclusions Hospitalized infants with fatal LOS manifest respiratory, cardiovascular, renal, immune, and hematologic dysfunction. Knowledge of these factors and their timing may be important for the development and testing of novel therapeutics to reduce sepsis mortality.

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Section: Discussionmentioning

confidence: 99%

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

et al. 2016

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“…An outbreak was defined as Ͼ6 MRSA infections within a 12-month period. Prolonged rupture of membranes (13), chorioamnionitis (13), bronchopulmonary dysplasia (BPD) (14), necrotizing enterocolitis (NEC) (15), and late-onset sepsis were defined as described previously (16).…”

Section: Methodsmentioning

confidence: 99%

Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit in the Decade following Implementation of an Active Detection and Isolation Program

et al. 2015

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1, 2). The National Nosocomial Infections Surveillance System observed a Ͼ300% increase in the incidence of late-onset MRSA infections in NICUs, from 0.7 to 3.1 infections/10,000 patient days, between 1995 and 2004 (3). Unique host and environmental factors, including immature immune systems, high frequency of contact with health care providers (4), exposure to numerous invasive procedures, NICU overcrowding and understaffing (5, 6), and prolonged hospitalization (7), make NICU patients at especially high risk of becoming colonized and infected with MRSA. Since colonization with MRSA is a risk factor for development of MRSA infection, prevention of MRSA transmission within the NICU is critical (7,8). Many NICUs have implemented active detection and isolation (ADI) programs, which involve surveillance to rapidly identify affected patients, followed by cohorting and isolation with standard contact precautions, in attempts to prevent MRSA transmission and reduce infection rates.Several large NICUs have published reports regarding the clinical epidemiology of neonatal MRSA following implementation of surveillance, transmission prevention, and/or decolonization strategies (7,(9)(10)(11)(12). Some also incorporated molecular analyses in their studies, including antibiotic susceptibility testing (9, 10), strain typing (9, 11, 12), genotyping (9, 12), and/or Panton-Valentine leukocidin gene detection (9,12). No studies have comprehensively examined all of those molecular features of MRSA and additionally assessed the presence or absence of genes encoding proteins for a variety of staphylococcal toxins and potential virulence factors over an extensive time period following implementation of an ADI program in an NICU.In response to the appearance of MRSA in the NICU at YaleNew Haven Children's Hospital (YNHCH)

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“…19 El centro hospitalario donde se realizó el estudio se apega a las características poblacionales de la mayor parte de las ciudades. Las causas de las defunciones concuerdan con lo reportado en la epidemiología de México y del mundo.…”

Section: Discussionunclassified

Desarrollo y validación de la Escala de Mortalidad Neonatal-9 México para predecir la mortalidad en neonatos críticamente enfermos

Márquez-González¹,

Jiménez-Báez²,

Muñoz-Ramírez

et al. 2015

arch Argent Pediat

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Clinical and Laboratory Factors That Predict Death in Very Low Birth Weight Infants Presenting With Late-onset Sepsis

Cited by 53 publications

References 21 publications

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis

Clinical and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive Care Unit in the Decade following Implementation of an Active Detection and Isolation Program

Desarrollo y validación de la Escala de Mortalidad Neonatal-9 México para predecir la mortalidad en neonatos críticamente enfermos

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