Neurodevelopmental outcome after nosocomial sepsis in preterm neonates: a retrospective cohort study

Abstract

Background Nosocomial infections (NIs) are associated with significant mortality affecting up to 56% of all infants, as well as long-term morbidity, prolonged hospital stay, and increased healthcare costs. Objective This study aimed to compare neurodevelopmental outcomes at 18 months of age in preterm infants exposed to nosocomial sepsis (NS) during neonatal ICU admission with the outcomes in unexposed preterm infants. Study design This was a retrospective study in the follow-up clinic of the neonatal ICU of a tertiary hospital. Participants Preterm infants who met the criteria were divided into: group A exposed to NS and group B not exposed to NS. Intervention All infants were examined across the three domains of neurodevelopment: cognitive function, language, and motor function. The examination was done at 18 months of corrected age, using the Bayley Scales of Infant and Toddler Development (III). Outcome The neurodevelopment of preterm infants at 18 months of age. Results Among the 61 former preterm infants at 18 months of age, who met the criteria, 31 were exposed and 30 were not exposed to NS. Male infants, low birth weight, and low APGAR score were significantly higher in the nosocomial group. Gram-negative organisms accounted for 60% of cases. Staphylococci accounted for 16.7% of the cultures. The neurodevelopmental delay was more in the sepsis group than in the nonsepsis group in all functions examined, and the difference was significant, and sepsis cases accounted for about 2/3 of the cases that had neurodevelopmental impairment. Conclusion This study showed that neurodevelopmental impairment was significantly increased in neonates who developed NI despite treatment with effective antibiotic therapy.