Abstract
BackgroundLate-Onset Bloodstream Infections (LO-BSI) continue to be one of the most important complications associated with hospitalization of infants born with very low birth weight (VLBW). The aims of this study were to assess the epidemiology of LO-BSI together with the risk factors and the distribution of causative pathogens at six Polish neonatal intensive care units that participated in the Polish Neonatology Surveillance Network from January 1, 2009 to December 31, 2011.MethodsThe surveillance covered 1,695 infants whose birth weights were <1501 grams (VLBW) in whom LO-BSI was diagnosed >72 hours after delivery. Case LO-BSI patients were defined according to NeoKISS.ResultsFour hundred twenty seven episodes of LO-BSI were diagnosed with a frequency of 25.3% and an incidence density of 6.7/1000 patient-days (pds). Results of our multivariate analysis demonstrated that surgical procedures and lower gestational age were significantly associated with the risk of LO-BSI. Intravascular catheters were used in infants with LO-BSI significantly more frequently and/or for longer duration: Central venous cathters (CVC) (OR 1.29) and Peripheral venous catheters (PVC) (OR 2.8), as well as, the total duration of total parenteral nutrition (13 vs. 29 days; OR 1.81). Occurrence of LO-BSI was significantly associated with increased the length of mechanical ventilation (MV) (OR 2.65) or the continuous positive airway pressure (CPAP) (OR 2.51), as well as, the duration of antibiotic use (OR 2.98). The occurrence of more than one infection was observed frequently (OR 9.2) with VLBW with LO-BSI. Microorganisms isolated in infants with LO-BSI were dominated by Gram-positive cocci, and predominantly by coagulase-negative staphylococci (62.5%).ConclusionsIndependent risk factor for LO-BSI in VLBV infants are: low gestational age and requirement for surgery. The incidence rates of LO-BSI especially CVC-BSI were higher in the Polish NICUs surveillance than those of other national networks, similar to the central- and peripheral utilization ratio.
Highlights
Late-Onset Bloodstream Infections (LO-blood stream infections (BSI)) continue to be one of the most important complications associated with hospitalization of infants born with very low birth weight (VLBW)
The epidemiology of infections among neonatal intensive care units (NICUs) in the USA has been explored through the National Healthcare Safety Network (NHSN) system of the Centers for Disease Control and Prevention (CDC); limited information has been available from the European countries
Gram-negative rod infections were mostly observed among Late-Onset Bloodstream Infections (LO-BSI) in patients without prolonged use of vascular lines; we found a lower frequency of gram-negative rod infections than have been reported in the UK [11], Taiwan [24], Germany [9], or U.S.A. [28]
Summary
Late-Onset Bloodstream Infections (LO-BSI) continue to be one of the most important complications associated with hospitalization of infants born with very low birth weight (VLBW). The aims of this study were to assess the epidemiology of LO-BSI together with the risk factors and the distribution of causative pathogens at six Polish neonatal intensive care units that participated in the Polish Neonatology Surveillance Network from January 1, 2009 to December 31, 2011. Late-Onset Bloodstream Infections (LO-BSI) continue as a critical complication associated with hospitalization of very low birth weight (VLBW) infants. LO-BSI contributes to morbidity, mortality, and other long-term adverse outcomes [1,2,3,4,5] Surveillance of these infants, especially blood stream infections (BSI) was introduced in intensive care. A second aim was to implement uniform definitions, specimen acquisition, and culturing techniques for infection surveillance: continuous, systematic collection, analysis and interpretation of health-related and infections data
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