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Neonatal sepsis incidence in preterm infants treated with standard care in an open bay in a level 2 Neonatal ward,2009-2012.

(2016) Dalen, R.C. (Runa)

Background and objective Neonatal sepsis is a severe disease in preterm infants that can
result in significant morbidity in this vulnerable patient group. Our aim was to identify and
assess the risk factors and incidence of neonatal sepsis in two different groups of preterm
infants (very preterm-and moderate to late preterm infants) in a level 2 neonatal ward.
Methods We conducted a retrospective cohort study in preterm infants with a gestational age
(GA) of <36weeks transferred to or born in our centre from 2009 to 2012. Sepsis was defined
as a positive blood culture and clinical symptoms, with early -and late onset sepsis defined as
onset of symptoms before 72 hours and after 72 hours of life, respectively. Univariate and
multivariate logistic analyses were performed.
Results We included 163 very preterm infants (GA<32weeks) and 434 moderate-to late
preterm infants (GA 32-36weeks). Neonatal sepsis was found in 6% (36/597) of preterm
infants. There was a significant association between the type of group a neonate belonged to
(according to GA) and whether or not sepsis was diagnosed (p < 0.002). The odds of sepsis
for neonates were 2.7 times higher if they were born with a GA <32 weeks (group A) than if
they were born with a GA 32- 36 weeks (group B). Early-onset sepsis (EOS) with group B
streptococcus occurred in one late preterm infant (0.7%) of 146 suspected episodes. Lateonset
sepsis (LOS) occurred in 35 preterm infants of a total of 90 suspected episodes (39%).
Coagulase-negative staphylococci was the most frequently pathogen isolated in LOS. Total
parenteral nutrition administration, vaginal spontaneous birth and gestational age were
significantly associated with LOS.
Conclusion This study shows a very low prevalence of EOS and LOS in both very preterm
and moderate preterm infants. Vaginal spontaneous birth was found to be a significant
protective factor for LOS. TPN administration (by central venous catheter, peripheral inserted
catheter), vaginal spontaneous birth and lower GA were found to be significant risk factors
for development of LOS.





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ID 3353
Moeder ID 3084
Volgorde Dalen, R.C.
Naam DalenRC
Publiceren yes
OAI-naam Student_thesis
Path root/geneeskunde/2016/DalenRC/
Gemaakt op: 2017-03-07 08:51:18
Gemodificeerd op: 2017-03-07 08:51:18
Digitaal ID 58be748609162
Afstudeerrichting opleiding/afstudeerrichting 1
Studierichting Studierichting 1
Titel Neonatal sepsis incidence in preterm infants treated with standard care in an open bay in a level 2 Neonatal ward,2009-2012.
Ruilverkeer mogelijk no
Printen in opdracht no
Aantal pagina's 29
Publicatiejaar 2016
Taal en
Engelse samenvatting Background and objective Neonatal sepsis is a severe disease in preterm infants that can
result in significant morbidity in this vulnerable patient group. Our aim was to identify and
assess the risk factors and incidence of neonatal sepsis in two different groups of preterm
infants (very preterm-and moderate to late preterm infants) in a level 2 neonatal ward.
Methods We conducted a retrospective cohort study in preterm infants with a gestational age
(GA) of <36weeks transferred to or born in our centre from 2009 to 2012. Sepsis was defined
as a positive blood culture and clinical symptoms, with early -and late onset sepsis defined as
onset of symptoms before 72 hours and after 72 hours of life, respectively. Univariate and
multivariate logistic analyses were performed.
Results We included 163 very preterm infants (GA<32weeks) and 434 moderate-to late
preterm infants (GA 32-36weeks). Neonatal sepsis was found in 6% (36/597) of preterm
infants. There was a significant association between the type of group a neonate belonged to
(according to GA) and whether or not sepsis was diagnosed (p < 0.002). The odds of sepsis
for neonates were 2.7 times higher if they were born with a GA <32 weeks (group A) than if
they were born with a GA 32- 36 weeks (group B). Early-onset sepsis (EOS) with group B
streptococcus occurred in one late preterm infant (0.7%) of 146 suspected episodes. Lateonset
sepsis (LOS) occurred in 35 preterm infants of a total of 90 suspected episodes (39%).
Coagulase-negative staphylococci was the most frequently pathogen isolated in LOS. Total
parenteral nutrition administration, vaginal spontaneous birth and gestational age were
significantly associated with LOS.
Conclusion This study shows a very low prevalence of EOS and LOS in both very preterm
and moderate preterm infants. Vaginal spontaneous birth was found to be a significant
protective factor for LOS. TPN administration (by central venous catheter, peripheral inserted
catheter), vaginal spontaneous birth and lower GA were found to be significant risk factors
for development of LOS.
Nederlandse samenvatting Inleiding Neonatale sepsis is een ernstig ziektebeeld bij prematuren en kan leiden tot
significante morbiditeit met mogelijke negatieve lange termijn effecten.
Doel Deze retrospectieve studie is verricht om de risicofactoren en de incidentie van
neonatale sepsis bij 2 verschillende groepen prematuren te onderzoeken in een level 2
ziekenhuis.
Methode We hebben sepsis data verzameld van 2 verschillende groepen prematuren: groep A
zwangerschapsduur <32 weken, en groep B zwangerschapsduur 32-36 weken gedurende de
periode 2009-2012. Sepsis was gedefinieerd als een positieve bloedkweek met een klinische
verdenking, waarbij early onset sepsis (EOS) de eerste 72 uur postpartum optreedt en late
onset sepsis (LOS) 72 uur postpartum. Univariate and multivariate logistische analyse
werden toegepast.
Resultaten Groep A bestond uit 163 prematuren en groep B uit 434 prematuren. Van de
totale groep ontwikkelde 36/597 (6%) een episode van neonatale sepsis. Er was een
significant verschil tussen de groepen voor wat betreft zwangerschapsduur en bewezen sepsis
(p < .002). Het risico op het krijgen van sepsis voor neonaten met een zwangerschapsduur
<32 weken was 2,7 keer zo groot als in neonaten met een zwangerschapsduur van 32-36
weken (groep B). Er was 1 EOS met groep B streptokokken in groep B van 146 klinische
verdenkingen (0,7%). LOS werd bij 35 neonaten (39%) gediagnosticeerd bij de 90 verdachte
gevallen, 18 in groep A en 17 in groep B. Coagulase negatieve stafylococcus was de meest
voorkomende pathogeen geisoleerd in de LOS groep. Spontane vaginale baring, toediening
van totale parenterale voeding (TPV) en zwangerschapsduur waren significant geassocieerd
met LOS.
Conclusie De incidentie van zowel vroege als late sepsis is zeer laag in zowel extreme als late
prematuren in een level 2 ziekenhuis. Spontane vaginale baring bleek een significante
beschermende factor tegen LOS. Verder, bleek dat toediening van TPV en
zwangerschapsduur significante determinanten waren voor het krijgen van LOS.
Onderwijsinstelling Medical Sciences
Type embargo abstract openbaar, scriptie op aanvraag
Auteur(s) Dalen, R.C. (Runa)
UMCG begeleider(s) Faculty supervisor:; Koper, Drs. J. F. neonatologist; UMCG, the Netherlands
Begeleider(s) opleidingsinstelling Second supervisor:; Schoor, Dr. S.R.D. van der; neonatologist; OLVG East, the Netherlands
Auteur(s) Dalen, R.C. (Runa)
UMCG begeleider(s) Faculty supervisor:; Koper, Drs. J. F. neonatologist; UMCG, the Netherlands


 
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