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Risk factors for health care-associated sepsis in critically ill neonates stratified by birth weight

Evelien Verstraete UGent, KRIS DE COEN, Dirk Vogelaers UGent and Stijn Blot UGent (2015) PEDIATRIC INFECTIOUS DISEASE JOURNAL. 34(11). p.1180-1186
abstract
Background: Health care-associated bloodstream infection (HABSI) is a frequent complication in neonatal intensive care. Research on risk factors stratified by birth weight and adjusted for severity of illness and comorbidities is limited. Our objective is to describe independent risk factors for HABSI in critically ill neonates with emphasis on risk variation between birth weight groups. Methods: We performed a single-center historical cohort study in a tertiary referral center. A neonatal intensive care-audit system was used to identify eligible neonates admitted for 72 hours (2002-2011). HABSI is defined according to National Institute of Child Health and Human Development criteria. Risk factors for HABSI were assessed by univariate and logistic regression analysis for the total cohort and for birth weight subgroups, that is, neonates 1500g and >1500g. Results: A total of 342 neonates developed HABSI in 5134 admissions of 72 hours (6.7%). Very low birth weight, total parenteral nutrition (TPN), mechanical ventilation, gastrointestinal disease, surgery (cardiac and other type), and renal insufficiency are independent risk factors for the total cohort. Gastrointestinal disease and cardiac surgery are independent risk factors in both birth weight groups; mechanical ventilation (odds ratio [OR]: 2.6; confidence interval [CI]: 1.6-4.0) and other type of surgery (OR: 4.3; CI: 2.1-8.8) are solely independent risk factors in the 1500-g cohort; TPN is exclusively an independent risk factor (OR: 7.9; CI: 3.9-16.2) in the >1500-g cohort. Conclusions: In our neonatal intensive care unit, risk stratification by birth weight revealed some difference. Special attention concerning infection control practices is for neonates receiving TPN, mechanical ventilation, cardiac surgery, and with a gastrointestinal disease.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
newborn, sepsis, risk factor, logistic regression, BLOOD-STREAM INFECTIONS, LATE-ONSET SEPSIS, NEGATIVE STAPHYLOCOCCAL BACTEREMIA, NOSOCOMIAL INFECTION, RESEARCH NETWORK, PRETERM INFANTS, UNIT, SURVEILLANCE, BABIES, INDEX
journal title
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Pediatr. Infect. Dis. J.
volume
34
issue
11
pages
1180 - 1186
Web of Science type
Article
Web of Science id
000363530500007
JCR category
PEDIATRICS
JCR impact factor
2.587 (2015)
JCR rank
22/120 (2015)
JCR quartile
1 (2015)
ISSN
0891-3668
DOI
10.1097/INF.0000000000000851
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
6964774
handle
http://hdl.handle.net/1854/LU-6964774
date created
2015-10-21 16:29:34
date last changed
2017-03-08 12:34:19
@article{6964774,
  abstract     = {Background: Health care-associated bloodstream infection (HABSI) is a frequent complication in neonatal intensive care. Research on risk factors stratified by birth weight and adjusted for severity of illness and comorbidities is limited. Our objective is to describe independent risk factors for HABSI in critically ill neonates with emphasis on risk variation between birth weight groups. 
Methods: We performed a single-center historical cohort study in a tertiary referral center. A neonatal intensive care-audit system was used to identify eligible neonates admitted for 72 hours (2002-2011). HABSI is defined according to National Institute of Child Health and Human Development criteria. Risk factors for HABSI were assessed by univariate and logistic regression analysis for the total cohort and for birth weight subgroups, that is, neonates 1500g and {\textrangle}1500g. 
Results: A total of 342 neonates developed HABSI in 5134 admissions of 72 hours (6.7\%). Very low birth weight, total parenteral nutrition (TPN), mechanical ventilation, gastrointestinal disease, surgery (cardiac and other type), and renal insufficiency are independent risk factors for the total cohort. Gastrointestinal disease and cardiac surgery are independent risk factors in both birth weight groups; mechanical ventilation (odds ratio [OR]: 2.6; confidence interval [CI]: 1.6-4.0) and other type of surgery (OR: 4.3; CI: 2.1-8.8) are solely independent risk factors in the 1500-g cohort; TPN is exclusively an independent risk factor (OR: 7.9; CI: 3.9-16.2) in the {\textrangle}1500-g cohort. 
Conclusions: In our neonatal intensive care unit, risk stratification by birth weight revealed some difference. Special attention concerning infection control practices is for neonates receiving TPN, mechanical ventilation, cardiac surgery, and with a gastrointestinal disease.},
  author       = {Verstraete, Evelien and DE COEN, KRIS and Vogelaers, Dirk and Blot, Stijn},
  issn         = {0891-3668},
  journal      = {PEDIATRIC INFECTIOUS DISEASE JOURNAL},
  keyword      = {newborn,sepsis,risk factor,logistic regression,BLOOD-STREAM INFECTIONS,LATE-ONSET SEPSIS,NEGATIVE STAPHYLOCOCCAL BACTEREMIA,NOSOCOMIAL INFECTION,RESEARCH NETWORK,PRETERM INFANTS,UNIT,SURVEILLANCE,BABIES,INDEX},
  language     = {eng},
  number       = {11},
  pages        = {1180--1186},
  title        = {Risk factors for health care-associated sepsis in critically ill neonates stratified by birth weight},
  url          = {http://dx.doi.org/10.1097/INF.0000000000000851},
  volume       = {34},
  year         = {2015},
}

Chicago
Verstraete, Evelien, KRIS DE COEN, Dirk Vogelaers, and Stijn Blot. 2015. “Risk Factors for Health Care-associated Sepsis in Critically Ill Neonates Stratified by Birth Weight.” Pediatric Infectious Disease Journal 34 (11): 1180–1186.
APA
Verstraete, Evelien, DE COEN, K., Vogelaers, D., & Blot, S. (2015). Risk factors for health care-associated sepsis in critically ill neonates stratified by birth weight. PEDIATRIC INFECTIOUS DISEASE JOURNAL, 34(11), 1180–1186.
Vancouver
1.
Verstraete E, DE COEN K, Vogelaers D, Blot S. Risk factors for health care-associated sepsis in critically ill neonates stratified by birth weight. PEDIATRIC INFECTIOUS DISEASE JOURNAL. 2015;34(11):1180–6.
MLA
Verstraete, Evelien, KRIS DE COEN, Dirk Vogelaers, et al. “Risk Factors for Health Care-associated Sepsis in Critically Ill Neonates Stratified by Birth Weight.” PEDIATRIC INFECTIOUS DISEASE JOURNAL 34.11 (2015): 1180–1186. Print.