Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants

Fanaroff, Avroy A.; Korones, Sheldon B.; Wright, Linda L.; Verter, Joel; Poland, Ronald L.; Bauer, Charles R.; Tyson, Jon E.; Philips, Joseph B.; Edwards, William H.; Lucey, Jerold F.; Catz, Charlotte; Shankaran, Seetha; Oh, William

doi:10.1097/00006454-199807000-00004

Cited by 391 publications

(280 citation statements)

References 16 publications

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“…That study, however, included both preterm VLBW and term newborns with sepsis, most of which were of early-onset and not cultureproven. Even using the reference ranges as proposed by Manroe et al 8 for mature infants, Fanaroff et al 13 also reported only an 8% incidence neutropenia (ANC <1500/mm 3 ) in infants with late-onset sepsis. In their large multicentric trial, more than twothirds of cases were caused by Gram-negative organisms.…”

Section: Discussionmentioning

confidence: 99%

Can neutrophil responses in very low birth weight infants predict the organisms responsible for late-onset bacterial or fungal sepsis?

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Can neutrophil responses in very low birth weight infants predict the organisms responsible for late-onset bacterial or fungal sepsis?

et al. 2006

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“…1,2 Infection is a major cause of mortality and morbidity among VLBW infants (birth weight <1500 g). 3,4 Systemic candidiasis has become increasingly important as a cause of infection in VLBW infants. [5][6][7] Neonatal candidemia occurs in 1.6 to 9% of VLBW infants 1,2 and 4 to 15% in extremely low birth weight infants (ELBW; birth weight <1000 g), with the 30-day mortality approaching 40%.…”

Section: Introductionmentioning

confidence: 99%

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

Bharwani

Dhanireddy

2007

J Perinatol

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Objective: To study the association between systemic fungal infection (SFI) and the development of retinopathy of prematurity (ROP) and severe ROP in very low birth weight (VLBW) infants by systematic review and meta-analysis.Study Design: A meta-review was performed using a fixed effects model. The exposure and outcomes studied were SFI and all ROP/severe ROP, respectively in VLBW infants. Results and effect sizes analyzed with Review Manager 4.2 software are expressed as relative risk (RR), odds ratio (OR), risk difference (RD) and number needed to harm (NNH) with 95% confidence intervals.Result: Data for severe ROP were available from eight studies and on all ROP from seven of those eight studies. Estimated gestational age ranged from 24.7±1.6 to 28.6±4 weeks and birth weight from 673 (median) (range 426 to 995) to 1108 ± 266 g (mean ± s.d.). A total of 261 of 303 babies with SFI had all ROP vs 1081 of 1648 babies without SFI (OR 3.4*, 2.34-4.95) and 118 of 330 babies with SFI had severe ROP vs 235 of 1951 babies without SFI (OR 4.06*,). The NNH was 5.56* (4.54-7.14) for all ROP and 4.54* (3.70 to 5.88) for severe ROP (*P<0.00001).Conclusion: SFIs are associated with the development of all degrees of ROP and severe ROP in VLBW infants.

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“…In early-onset sepsis, criteria for diagnosis are relatively well established, 1 but such criteria cannot be used with LNS because of known differences in risk factors, clinical features, and causative pathogens. 2 Few clinical scoring methods for the prediction of LNS have been developed, and they were mainly from the data of the neonates who had been worked-up as suspected sepsis. [3][4][5] The objectives of this study were to develop a practical, clinical prediction-scoring model for the diagnosis of LNS, and to validate the diagnostic performance of the model.…”

Section: Introductionmentioning

confidence: 99%

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

et al. 2005

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OBJECTIVE:Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this study. The objective was to develop and validate a simple prediction-scoring model for LNS defined as culture-proven sepsis occurring 72 hours after birth. METHODS:The study was performed at a university hospital in Bangkok. The derivation phase included medical records of 1870 neonates, randomly selected from 9347 records of neonates who had been hospitalized for >72 hours during 1998 to 2000, of which 1824 records were available. In all, 100 neonates were clinically suspected of sepsis and 17 had proven LNS. The validation phase included 73 neonates suspected of having sepsis during July 2002to June 2003 and 25 who had LNS. Weighted coefficients from Cox's proportional hazards model and receiveroperating-characteristic (ROC) curve analysis were used. RESULTS:The incidence density of LNS was 17/11355 (1.5/1000) person-days. A scoring model was developed and consisted of the following: hypotension (score 4), abnormal body temperature (score 3), respiratory insufficiency (score 2), neutrophil band form fraction >1% (score 2), platelet count <150 Â 10 3 /ml (score 2), and umbilical venous catheterization (1 to 7 or >7 days; score 2 or 4). The area under the ROC curves for prediction of LNS in a neonate suspected of sepsis in each of the two phases was 0.85 and 0.80, respectively (p ¼ 0.436). The mean probabilities of LNS were approximately 0.10 (low risk) for scores from 0 to 3; 0.50 (intermediate risk) for scores from 4 to 6; and 0.70 (high risk) for scores Z7. CONCLUSION:A simple prediction-scoring model for LNS was developed. Validation of the scores suggested good diagnostic performance.

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Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants

Cited by 391 publications

References 16 publications

Can neutrophil responses in very low birth weight infants predict the organisms responsible for late-onset bacterial or fungal sepsis?

Can neutrophil responses in very low birth weight infants predict the organisms responsible for late-onset bacterial or fungal sepsis?

Systemic fungal infection is associated with the development of retinopathy of prematurity in very low birth weight infants: a meta-review

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

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