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. 2009 Dec;28(12):1052-6.
doi: 10.1097/inf.0b013e3181acf6bd.

Early and late onset sepsis in late preterm infants

Michael Cohen-Wolkowiez  1 , Cassandra Moran, Daniel K Benjamin, C Michael Cotten, Reese H Clark, Daniel K Benjamin Jr, P Brian Smith
Affiliations

Early and late onset sepsis in late preterm infants

Michael Cohen-Wolkowiez et al. Pediatr Infect Dis J. 2009 Dec.

Abstract

Background: Preterm birth is increasing worldwide, and late preterm births, which comprise more than 70% of all preterm births, account for much of the increase. Early and late onset sepsis results in significant mortality in extremely preterm infants, but little is known about sepsis outcomes in late preterm infants.

Methods: This is an observational cohort study of infants <121 days of age (119,130 infants less than or equal to 3 days of life and 106,142 infants between 4 and 120 days of life) with estimated gestational age at birth between 34 and 36 weeks, admitted to 248 neonatal intensive care units in the United States between 1996 and 2007.

Results: During the study period, the cumulative incidence of early and late onset sepsis was 4.42 and 6.30 episodes per 1000 admissions, respectively. Gram-positive organisms caused the majority of early and late onset sepsis episodes. Infants with early onset sepsis caused by Gram-negative rods and infants with late onset sepsis were more likely to die than their peers with sterile blood cultures (odds ratio [OR]: 4.39, 95% CI: 1.71-11.23, P = 0.002; and OR: 3.37, 95% CI: 2.35-4.84, P < 0.001, respectively).

Conclusion: Late preterm infants demonstrate specific infection rates, pathogen distribution, and mortality associated with early and late onset sepsis. The results of this study are generalizable to late preterm infants admitted to the special care nursery or neonatal intensive care unit.

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Conflict of interest statement

The authors declare that they have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Odds ratios for early and late onset sepsis associated with selected variables among late preterm infants by multivariable regression analysis. BW indicates birth weight; CI, confidence interval; EOS, early onset sepsis; LOS, late onset sepsis.
Figure 2
Figure 2
Group-B streptococci and Escherichia coli early onset sepsis annual cumulative incidence per 1000 late preterm NICU admissions between 1997 and 2007. EOS indicates early onset sepsis; GBS, group-B streptococci.
Figure 3
Figure 3
Infection episodes by organism group and postnatal age among late preterm infants with late onset sepsis. CoNS indicates coagulase-negative Staphylococcus; GNR, Gram-negative rods; GPC, Gram-positive cocci; LOS, late-onset sepsis; NICU, neonatal intensive care unit.
See this image and copyright information in PMC

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