Mortality following blood culture in premature infants: Increased with Gram-negative bacteremia and candidemia but not Gram-positive bacteremia

被引：91

作者：

Benjamin Jr. D.K. ^{[1
,2
]}

DeLong E. ^{[2
]}

Cotten C.M. ^{[2
]}

Garges H.P. ^{[2
]}

Steinbach W.J. ^{[2
]}

Clark R.H. ^{[3
]}

机构：

[1] Duke Clinical Research Institute, Durham, NC 27715

[2] Duke University Dept. of Pediatrics, Durham, NC

[3] Pediatrix Medical Group Inc., Sunrise, FL

来源：

Journal of Perinatology | 2004年 / 24卷 / 3期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1038/sj.jp.7211068

中图分类号：

学科分类号：

摘要：

Objective: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. Study Design: Multicenter cohort study of premature infants. Results: First blood culture was negative for 4648/5497 (78%) of the neonates - 390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR) = 2.61] and candidemia (HR = 2.27) were associated with increased mortality; CONS (HR = 1.08) and GP-o (HR = 0.97) were not.7 Conclusions: Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Grum-positive bacteremia was not. © 2004 Nature Publishing Group All rights reserved.

引用

页码：175 / 180

页数：5

共 12 条

[1]

Chapman R.L., Faix R.G., Persistent bacteremia and outcome in late onset infection among infants in a neonatal intensive care unit, Pediatr. Dis. J., 22, pp. 17-21, (2003)

[2]

Hemming V.G., Overall Jr. J.C., Britt M.R., Nosocomial infections in a newborn intensive-care unit. Results of forty-one months of surveillance, N. Engl. J. Med., 291, pp. 1310-1316, (1976)

[3]

Leibovitz E., Flidel-Rimon O., Juster-Reicher A., Et al., Sepsis at a neonatal intensive care unit: A four-year retrospective study (1989-1992), Isr. J. Med. Sci., 33, pp. 734-738, (1997)

[4]

Karlowicz M.G., Buescher E.S., Surka A.E., Fulminant late-onset sepsis in a neonatal intensive care unit 1988-1997, and the impact of avoiding empiric vancomycin therapy, Pediatrics, 106, pp. 1387-1390, (2000)

[5]

Stoll B.J., Holman R.C., Schuchat A., Decline in sepsis-associated neonatal and infant deaths in the United States, 1979 through 1994, Pediatrics, 102, (1998)

[6]

Stoll B.J., Hansen N., Fanaroff A.A., Et al., Late-onset in very low birth weight neonates: The experience of the NICHD Neonatal Research Network, Pediatrics, 110, pp. 285-291, (2002)

[7]

Thorp J.A., Jones P.G., Peabody P.L., Knox E., Clark R.H., Effect of antenatal and postnatal corticosteriod therapy on weight gain and head circumference growth in the nursery, Obstet. Gynecol., 99, pp. 109-115, (2002)

[8]

Freeman J., Platt R., Sidebottom D.G., Leclair J.M., Epstein M.F., Goldmann D.A., Coagulase-negative staphylococcal bacteremia in the changing neonatal intensive care unit population. Is there an epidemic?, JAMA, 258, pp. 2548-2552, (1987)

[9]

Stevenson D.K., Verter J., Fanaroff A.A., Et al., Sex differences in outcomes of very low birthweight infants: The newborn male disadvantage, Arch. Dis. Child Fetal. Neonat Ed., pp. 83-F182, (2000)

[10]

A national study of risk factors associated with mortality in very low birthweight infants in the Malaysian neonatal intensive care units, J. Paediatr. Child Health, 33, pp. 18-25, (1997)

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