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Neonatal sepsis in a rapidly growing, tertiary neonatal intensive care unit: Trends over 18 years
Author(s) -
Heo Ju Sun,
Shin Seung Han,
Jung Young Hwa,
Kim EeKyung,
Choi Eun Hwa,
Kim HanSuk,
Lee Hoan Jong,
Choi JungHwan
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12654
Subject(s) - medicine , neonatal intensive care unit , tertiary care , sepsis , intensive care unit , neonatal sepsis , pediatrics , intensive care medicine , tertiary level , emergency medicine , mathematics education , mathematics
Background We investigated changes in the admission patterns of neonatal intensive care units and the epidemiology of neonatal sepsis following the rapid expansion and improvements in neonatal intensive care. Methods Data on the admission of neonates with culture‐proven sepsis between 1996 and 2013 (period I, 1996–2005; period II, 2006–2013) were collected retrospectively. Results The admission of extremely low‐birthweight (ELBW) infants increased between periods I and II (11.1 vs 28.7 infants per 1000 live births, P < 0.001). The survival rate of the ELBW infants improved (57.5 vs 80.1%, P < 0.001), and duration of hospital stay increased (median, 64 vs 80 days, P = 0.001). The incidence of sepsis among all infants and ELBW infants increased (all infants, 5.9 vs 12.7 cases per 1000 live births; ELBW infants, 189.5 vs 290.1 cases per 1000 live births). In ELBW infants, the incidence of sepsis caused by coagulase‐negative Staphylococcus (CONS), significantly increased during period II (8.8 vs 25.4%, P = 0.039). On multivariate analysis, central vascular catheters and prolonged hospitalization were independently associated with increased sepsis rate, particularly CONS in ELBW infants. Conclusions The inborn admission rate for ELBW infants has increased significantly and is accompanied by improved survival and longer hospital stay. The incidence of neonatal sepsis, particularly in ELBW infants, has also increased, and CONS has emerged as a major pathogen. Central vascular catheters and prolonged hospitalization could be independent risk factors for the increased sepsis rate, particularly sepsis due to CONS.