Meningitis, urinary tract, and bloodstream infections in very low birth weight infants enrolled in a heart rate characteristics monitoring trial

Joern Hendrik Weitkamp, Judy L. Aschner, Wallly A. Carlo, Eduardo Bancalari, Jose A. Perez, Cristina T. Navarrete, Robert L. Schelonka, M. Whit Walker, Peter Porcelli, Thomas M. O’Shea, Charles Palmer, Sarah Grossarth, Douglas E. Lake, Karen D. Fairchild

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Displaying heart rate characteristic (HRC) scores was associated with lower sepsis-associated mortality in very low birth weight (VLBW) infants in a multicenter randomized controlled trial (HeRO trial). The aim of this study was to test whether HRC indices rise before diagnosis of urinary tract infection (UTI) or meningitis, with and without concomitant BSI. Methods: Blood, urine, and cerebrospinal fluid (CSF) culture data after 3 days of age and within 120 days of study enrollment were analyzed from 2989 VLBW infants. The HRC index was analyzed 12 h prior to positive cultures compared to 36 h prior, using paired signed-rank tests. Results: UTI, meningitis, and BSI were diagnosed in 10%, 2%, and 24% of infants, respectively. The mean hourly HRC index was significantly higher 12 h prior to diagnosis of UTI and BSI compared to 36 h prior (UTI 2.07 versus 1.81; BSI 2.62 versus 2.25, both p < 0.0001). The baseline HRC index was higher for meningitis, compared to UTI or BSI, but without a statistically significant rise in the day prior to meningitis diagnosis. Conclusions: In a large cohort of VLBW infants enrolled in the HeRO trial, the HRC index increased in the 24-h period prior to diagnosis of UTI and BSI but not meningitis.

Original languageEnglish (US)
Pages (from-to)1226-1230
Number of pages5
JournalPediatric Research
Volume87
Issue number7
DOIs
StatePublished - Jun 1 2020

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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