Neurodevelopmental outcome at 2\xa0years of age in preterm infants with late-onset sepsis

I A Zonnenberg,E M Van Dijk-Lokkart,M M Van Weissenbruch,F A M Van Den Dungen,R J Vermeulen

doi:10.1007/s00431-019-03339-2

Abstract

Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. This prospective cohort study aims to establish the effect of sepsis after 72 h of life on cognitive, psychomotor, and language development of preterm infants (below 32 weeks gestational age and/or below 1500 g). At 2 years corrected age, neurodevelopmental outcome was tested using Bayley’s Scales of Infant Development-II, Lexilijst (lexical development questionnaire), and behavior checklists. Of 117 patients included, 85 experienced blood culture–proven infection. Coagulase-negative staphylococci were responsible for 55% of the episodes. No significant differences were found in cognitive, motor, and behavioral scores or lexiquotient comparing patients with versus no proven infection. When comparing three groups (coagulase-negative staphylococci, other, and negative blood culture), a significant difference was found in composite cognitive scores (p = 0.016), in favor of the coagulase-negative staphylococci group versus other causal agent group (p = 0.007). No significant differences were found in other subscales.Conclusion: In this cohort, no differences were found in neurodevelopmental outcome at 2 years corrected age between proven and no proven infection groups; confirmation in larger cohorts with a control group is needed. Patients encountering coagulase-negative staphylococci sepsis showed a significant better cognitive outcome compared to other causal agents.What is Known:• Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants.What is New:• Preterm infants encountering late-onset sepsis by coagulase-negative staphylococci show a better cognitive outcome in comparison to other causal infectious agents in this cohort.• No differences were found in neurodevelopment at 2 years of age in preterm infants with suspected lateonset sepsis, between proven and no proven infection groups. Confirmation is needed in larger cohorts with a substantial control group.

Highlights

Long-term neurodevelopmental outcome is one of the most important outcome parameters of neonatal intensive care
Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants
A prospective cohort study was performed collecting data from preterm infants born with a gestational age < 32 weeks and/or < 1500 g admitted to the level III Neonatal Intensive Care Unit of the VU Medical Center between March 2008 and December 2014 suspected of late-onset sepsis

Summary

Introduction

Long-term neurodevelopmental outcome is one of the most important outcome parameters of neonatal intensive care. The long-term developmental outcome is, at risk due to the hazardous events that will occur during admission to the neonatal intensive care unit (NICU). These events are potentially dangerous for the brain development of the infants and may inflict delay in mental and/or psychomotor development. Examples of these events are respiratory or circulatory insufficiency, intracranial hemorrhage, or resuscitation. Another associated risk factor for impaired neurodevelopmental outcome is sepsis [1, 2]. Late-onset sepsis is associated with prolonged hospital stay, length of invasive ventilation, and need for invasive devices and parenteral nutrition [3]

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