Very low birth weight preterm infants with early onset neonatal sepsis: The predominance of Gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002-2003

Barbara J. Stoll, Nellie I. Hansen, Rosemary D. Higgins, Avroy A. Fanaroff, Shahnaz Duara, Ronald Goldberg, Abbot Laptook, Michelle Walsh, William Oh, Ellen Hale

Research output: Contribution to journalArticle

222 Citations (Scopus)

Abstract

Background: Early onset neonatal sepsis (EOS, occurring in the first 72 hours of life) remains an important cause of illness and death among very low birth weight (VLBW) preterm infants. We previously reported a change in the distribution of pathogens associated with EOS from predominantly Gram-positive to primarily Gram-negative organisms. Objective: To compare rates of EOS and pathogens associated with infection among VLBW infants born at centers of the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network during 3 time periods: 1991-1993; 1998-2000; and 2002-2003. Study Design: Prospectively collected data from the NICHD Neonatal Research Network VLBW registry were retrospectively reviewed. Rates of blood culture confirmed EOS, selected maternal and infant variables and pathogens associated with infection were compared between 2002-2003 and 2 previously published cohorts. Results: During the past 13 years, overall rates of EOS have remained stable (15-19 per 1000 live births of infants 401-1500 g). More than one-half of early infections in the 2002-2003 cohort were caused by Gram-negative organisms (53%), with Escherichia coli the most common organism (41%). Rates of group B streptococcal infections remain low (1.8 per 1000 live births). Between 1991-1993 and 1998-2000, there was a significant increase in rates of E. coli infections; but in 2002-2003, there was no significant change (7.0 per 1000 live births). Infants with EOS continue to be at significantly increased risk for death compared with uninfected infants. Conclusion: EOS remains an uncommon but important cause of morbidity and mortality among VLBW infants. Gram-negative organisms continue to be the predominant pathogens associated with EOS.

Original languageEnglish
Pages (from-to)635-639
Number of pages5
JournalPediatric Infectious Disease Journal
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2005

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National Institute of Child Health and Human Development (U.S.)
Very Low Birth Weight Infant
Premature Infants
Live Birth
Infection
Research
Escherichia coli Infections
Streptococcal Infections
Registries
Cause of Death
Mothers
Escherichia coli
Morbidity
Mortality
Neonatal Sepsis

Keywords

  • Early onset neonatal sepsis
  • Gram-negative infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Very low birth weight preterm infants with early onset neonatal sepsis : The predominance of Gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002-2003. / Stoll, Barbara J.; Hansen, Nellie I.; Higgins, Rosemary D.; Fanaroff, Avroy A.; Duara, Shahnaz; Goldberg, Ronald; Laptook, Abbot; Walsh, Michelle; Oh, William; Hale, Ellen.

In: Pediatric Infectious Disease Journal, Vol. 24, No. 7, 01.07.2005, p. 635-639.

Research output: Contribution to journalArticle

Stoll, Barbara J. ; Hansen, Nellie I. ; Higgins, Rosemary D. ; Fanaroff, Avroy A. ; Duara, Shahnaz ; Goldberg, Ronald ; Laptook, Abbot ; Walsh, Michelle ; Oh, William ; Hale, Ellen. / Very low birth weight preterm infants with early onset neonatal sepsis : The predominance of Gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002-2003. In: Pediatric Infectious Disease Journal. 2005 ; Vol. 24, No. 7. pp. 635-639.
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abstract = "Background: Early onset neonatal sepsis (EOS, occurring in the first 72 hours of life) remains an important cause of illness and death among very low birth weight (VLBW) preterm infants. We previously reported a change in the distribution of pathogens associated with EOS from predominantly Gram-positive to primarily Gram-negative organisms. Objective: To compare rates of EOS and pathogens associated with infection among VLBW infants born at centers of the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network during 3 time periods: 1991-1993; 1998-2000; and 2002-2003. Study Design: Prospectively collected data from the NICHD Neonatal Research Network VLBW registry were retrospectively reviewed. Rates of blood culture confirmed EOS, selected maternal and infant variables and pathogens associated with infection were compared between 2002-2003 and 2 previously published cohorts. Results: During the past 13 years, overall rates of EOS have remained stable (15-19 per 1000 live births of infants 401-1500 g). More than one-half of early infections in the 2002-2003 cohort were caused by Gram-negative organisms (53{\%}), with Escherichia coli the most common organism (41{\%}). Rates of group B streptococcal infections remain low (1.8 per 1000 live births). Between 1991-1993 and 1998-2000, there was a significant increase in rates of E. coli infections; but in 2002-2003, there was no significant change (7.0 per 1000 live births). Infants with EOS continue to be at significantly increased risk for death compared with uninfected infants. Conclusion: EOS remains an uncommon but important cause of morbidity and mortality among VLBW infants. Gram-negative organisms continue to be the predominant pathogens associated with EOS.",
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T1 - Very low birth weight preterm infants with early onset neonatal sepsis

T2 - The predominance of Gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002-2003

AU - Stoll, Barbara J.

AU - Hansen, Nellie I.

AU - Higgins, Rosemary D.

AU - Fanaroff, Avroy A.

AU - Duara, Shahnaz

AU - Goldberg, Ronald

AU - Laptook, Abbot

AU - Walsh, Michelle

AU - Oh, William

AU - Hale, Ellen

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Background: Early onset neonatal sepsis (EOS, occurring in the first 72 hours of life) remains an important cause of illness and death among very low birth weight (VLBW) preterm infants. We previously reported a change in the distribution of pathogens associated with EOS from predominantly Gram-positive to primarily Gram-negative organisms. Objective: To compare rates of EOS and pathogens associated with infection among VLBW infants born at centers of the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network during 3 time periods: 1991-1993; 1998-2000; and 2002-2003. Study Design: Prospectively collected data from the NICHD Neonatal Research Network VLBW registry were retrospectively reviewed. Rates of blood culture confirmed EOS, selected maternal and infant variables and pathogens associated with infection were compared between 2002-2003 and 2 previously published cohorts. Results: During the past 13 years, overall rates of EOS have remained stable (15-19 per 1000 live births of infants 401-1500 g). More than one-half of early infections in the 2002-2003 cohort were caused by Gram-negative organisms (53%), with Escherichia coli the most common organism (41%). Rates of group B streptococcal infections remain low (1.8 per 1000 live births). Between 1991-1993 and 1998-2000, there was a significant increase in rates of E. coli infections; but in 2002-2003, there was no significant change (7.0 per 1000 live births). Infants with EOS continue to be at significantly increased risk for death compared with uninfected infants. Conclusion: EOS remains an uncommon but important cause of morbidity and mortality among VLBW infants. Gram-negative organisms continue to be the predominant pathogens associated with EOS.

AB - Background: Early onset neonatal sepsis (EOS, occurring in the first 72 hours of life) remains an important cause of illness and death among very low birth weight (VLBW) preterm infants. We previously reported a change in the distribution of pathogens associated with EOS from predominantly Gram-positive to primarily Gram-negative organisms. Objective: To compare rates of EOS and pathogens associated with infection among VLBW infants born at centers of the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network during 3 time periods: 1991-1993; 1998-2000; and 2002-2003. Study Design: Prospectively collected data from the NICHD Neonatal Research Network VLBW registry were retrospectively reviewed. Rates of blood culture confirmed EOS, selected maternal and infant variables and pathogens associated with infection were compared between 2002-2003 and 2 previously published cohorts. Results: During the past 13 years, overall rates of EOS have remained stable (15-19 per 1000 live births of infants 401-1500 g). More than one-half of early infections in the 2002-2003 cohort were caused by Gram-negative organisms (53%), with Escherichia coli the most common organism (41%). Rates of group B streptococcal infections remain low (1.8 per 1000 live births). Between 1991-1993 and 1998-2000, there was a significant increase in rates of E. coli infections; but in 2002-2003, there was no significant change (7.0 per 1000 live births). Infants with EOS continue to be at significantly increased risk for death compared with uninfected infants. Conclusion: EOS remains an uncommon but important cause of morbidity and mortality among VLBW infants. Gram-negative organisms continue to be the predominant pathogens associated with EOS.

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KW - Gram-negative infections

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