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. 2014 Sep;33(9):920-3.
doi: 10.1097/INF.0000000000000322.

Late-onset bloodstream infections in hospitalized term infants

Daniela Testoni  1 , Madoka Hayashi, Michael Cohen-Wolkowiez, Daniel K Benjamin Jr, Renato D Lopes, Reese H Clark, Daniel K Benjamin, P Brian Smith
Affiliations

Late-onset bloodstream infections in hospitalized term infants

Daniela Testoni et al. Pediatr Infect Dis J. 2014 Sep.

Abstract

Background: The epidemiology and incidence of late-onset blood stream infections (BSIs) in premature infants have been described, but studies describing late-onset BSI in term infants are sparse. We sought to describe the pathogens, incidence, risk factors and mortality of late-onset BSI in hospitalized term infants.

Methods: A cohort study was conducted of infants ≥37 weeks gestational age and ≤120 days of age discharged from Pediatrix Medical Group neonatal intensive care units from 1997 to 2010. We examined all cultures obtained from day of life 4-120 and used multivariable regression to assess risk factors for late-onset BSI.

Results: We found a total of 206,019 infants cared for between day of life 4 and 120, and the incidence of late-onset BSI was 2.7/1000 admissions. We identified Gram-positive organisms in 64% of the cultures and Gram-negative organisms in 26%. We found a decreased risk of late-onset BSI in infants with the following characteristics: small for gestational age, delivery by Cesarean, antenatal antibiotic use and discharged in the later years of the study. Late-onset BSI increased the risk of death after controlling for confounders [odds ratio 8.43 (95% confidence interval 4.42-16.07)].

Conclusion: Our data highlight the importance of late-onset BSI in hospitalized term infants. We identified Gram-positive organisms as the most common pathogen, and late-onset BSI was an independent risk factor for death.

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Conflict of interest statement

Conflicts of Interest

The remaining authors have no potential conflicts to disclose.

Figures

Figure 1
Figure 1
Study population. DOL indicates day of life; GA, gestational age.
Figure 2
Figure 2
Incidence of late-onset sepsis bloodstream infection by year. CoNS indicates coagulase-negative staphylococci; GBS, group B Streptococcus.
See this image and copyright information in PMC

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