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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 (UGent) , Dirk Vogelaers (UGent) and Stijn Blot (UGent)
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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.
Keywords
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

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Please use this url to cite or link to this publication:

MLA
Verstraete, Evelien, et al. “Risk Factors for Health Care-Associated Sepsis in Critically Ill Neonates Stratified by Birth Weight.” PEDIATRIC INFECTIOUS DISEASE JOURNAL, vol. 34, no. 11, 2015, pp. 1180–86, doi:10.1097/INF.0000000000000851.
APA
Verstraete, E., 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. https://doi.org/10.1097/INF.0000000000000851
Chicago author-date
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): 1180–86. https://doi.org/10.1097/INF.0000000000000851.
Chicago author-date (all authors)
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. doi:10.1097/INF.0000000000000851.
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.
IEEE
[1]
E. Verstraete, K. De Coen, D. Vogelaers, and S. Blot, “Risk factors for health care-associated sepsis in critically ill neonates stratified by birth weight,” PEDIATRIC INFECTIOUS DISEASE JOURNAL, vol. 34, no. 11, pp. 1180–1186, 2015.
@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 >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.}},
  author       = {{Verstraete, Evelien and De Coen, Kris and Vogelaers, Dirk and Blot, Stijn}},
  issn         = {{0891-3668}},
  journal      = {{PEDIATRIC INFECTIOUS DISEASE JOURNAL}},
  keywords     = {{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://doi.org/10.1097/INF.0000000000000851}},
  volume       = {{34}},
  year         = {{2015}},
}

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