Browse > Article

Risk Factors of Nosocomial Sepsis in Very Low Birth Weight Infants  

Kim, Cu-Rie (Departments of Pediatrics, Eulji University School of Medicine)
Kim, Seung-Yeon (Departments of Pediatrics, Eulji University School of Medicine)
Park, Ho-Jin (Departments of Pediatrics, Eulji University School of Medicine)
Ki, Mo-Ran (Departments of Preventive Medicine, Eulji University School of Medicine)
Yoon, Hye-Sun (Departments of Pediatrics, Eulji University School of Medicine)
Publication Information
Neonatal Medicine / v.17, no.1, 2010 , pp. 84-93 More about this Journal
Abstract
Purpose : This study was performed to estimate the incidence of nosocomial sepsis and to identify the most relevant risk factors for nosocomial sepsis in high-risk very low birth weight (VLBW) infants. Methods : A retrospective review of 341 VLBW infants, admitted to the Neonatal Intensive Care Unit of the Eulji University Hospital (Daejeon & Seoul) between January 2002 and June 2009, who survived more than 72 hours was performed. The incidence, causative organisms, risk factors and prognosis of nosocomial sepsis in VLBW infants were analyzed. Results : The incidence of nosocomial sepsis was 16.1% and the onset date of nosocomial sepsis was 21.5$\pm$15.9 days (mean$\pm$SD) after delivery. Staphylococcus aureus (21.3%) was the most common organism in the patients with nosocomial sepsis in VLBW infants. The multiple logistic regression analysis showed that, gestational age [odds ratio (OR), 0.87; 95% CI, 0.83-0.91], umbilical artery catheter use for more than 5 days (OR, 2.2; 95% CI, 1.15-4.46), umbilical venous catheter use for more than 5 days (OR, 2.1; 95% CI, 1.11-4.16), peripheral arterial line use (OR, 2.1; 95% CI, 1.14-4.04) and intravenous intralipids (OR, 4.3;95% CI, 1.13-14.32) were identified as risk factors. Conclusion : The limited usage of intravascular catheter related procedures and the short providence of intravenous nutrition may decrease the incidence of nosocomial sepsis in VLBW infants.
Keywords
Nosocomial infection; Very low birth weight infant; Risk factor;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Bartels DB, Schwab F, Geffers C, Poets CF, Gastmeier P. Nosocomial infection in small for gestational age newborns with birth weight <1,500 g: a multicentre analysis. Arch Dis Child Fetal Neonatal Ed 2007;92:F449-53.   DOI
2 Kim KA, Shin SM, Choi JH. A nationwide survey on the causative organisms of neonatal sepsis in Korea. J Korean Pediatr Soc 2002;45:55-63.
3 Lee HY, Chung SH, Ko SY, Chang YS, Park WS A study on the incidence and risk factors of nosocomial sepsis in very low birth weight infants. J Korean Soc Neonatol 1999;6:90-7.
4 Makhoul IR, Sujov P, Smolkin T, Lusky A, Reichman B. Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey. Pediatrics 2002;109:34-9.   DOI   ScienceOn
5 Yoon HS. Statistics and medical cost of preterm in Korea. Hanyang Med Rev 2009;29:386-90.   DOI
6 Stoll BJ, Hansen N. Infections in VLBW infants: studies from the NICHD Neonatal Research Network. Semin Perinatol 2003;27:293-301.   DOI   ScienceOn
7 Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 2002;110:285-91.   DOI   ScienceOn
8 Su BH, Hsieh HY, Chiu HY, Lin HC. Nosocomial infection in a neonatal intensive care unit: a prospective study in Taiwan. Am J Infect Control 2007;35:190-5.   DOI   ScienceOn
9 Stoll BJ, Gordon T, Korones SB, Shankaran S, Tyson JE, Bauer CR, et al. Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network. J Pediatr 1996;129:63-71.   DOI   ScienceOn
10 Adams-Chapman I, Stoll BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr 2002;14:157-64.   DOI   ScienceOn
11 Yalaz M, Cetin H, Akisu M, Aydemir S, Tunger A, Kultursay N. Neonatal nosocomial sepsis in a level-III NICU: evaluation of the causative agents and antimicrobial susceptibilities. Turk J Pediatr 2006;48:13-8.
12 Graham PL 3rd, Begg MD, Larson E, Della-Latta P, Allen A, Saiman L. Risk factors for late onset gram-negative sepsis in low birth weight infants hospitalized in the neonatal intensive care unit. Pediatr Infect Dis J 2006;25:113-7.   DOI   ScienceOn
13 Kawagoe JY, Segre CA, Pereira CR, Cardoso MF, Silva CV, Fukushima JT. Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study. Am J Infect Control 2001;29:109-14.   DOI   ScienceOn
14 Auriti C, Maccallini A, Di Liso G, Di Ciommo V, Ronchetti MP, Orzalesi M. Risk factors for nosocomial infections in a neonatal intensive-care unit. J Hosp Infect 2003;53:25-30.   DOI   ScienceOn
15 Moro ML, De Toni A, Stolfi I, Carrieri MP, Braga M, Zunin C. Risk factors for nosocomial sepsis in newborn intensive and intermediate care units. Eur J Pediatr 1996;155:315-22.   DOI   ScienceOn
16 Olsen AL, Reinholdt J, Jensen AM, Andersen LP, Jensen ET. Nosocomial infection in a Danish Neonatal Intensive Care Unit: a prospective study. Acta Paediatr 2009;98:1294-9.   DOI   ScienceOn
17 Perlman SE, Saiman L, Larson EL. Risk factors for late-onset health care-associated bloodstream infections in patients in neonatal intensive care units. Am J Infect Control 2007;35:177-82.   DOI   ScienceOn
18 Flidel-Rimon O, Friedman S, Lev E, Juster-Reicher A, Amitay M, Shinwell ES. Early enteral feeding and nosocomial sepsis in very low birth-weight infants. Arch Dis Child Fetal Neonatal Ed 2004;89:F289-92.   DOI
19 Mahieu LM, De Dooy JJ, Lenaerts AE, Ieven MM, De Muynck AO. Catheter manipulations and the risk of catheter-associated bloodstream infection in neonatal intensive care unit patients. J Hosp Infect 2001;48:20-6.   DOI   ScienceOn
20 Kim CR, Oh JW, Yum MK, Moon SJ. Risk factors for neonatal sepsis in premature infants admitted to neonatal intensive care unit. J Korean Pediatr Soc 2000;43:1174-9.
21 Ronnestad A, Abrahamsen TG, Medbo S, Reigstad H, Lossius K, Kaaresen PI, et al. Late-onset septicemia in a Norwegian national cohort of extremely premature infants receiving very early full human milk feeding. Pediatrics 2005;115:e269-76.   DOI   ScienceOn