Outcome of early-onset sepsis in a national cohort of very low birth weight infants.
BACKGROUND
Early-onset sepsis (EOS) is associated with significant morbidity and mortality among infants with a very low birth weight (VLBW); however, there is a sparse amount of complete data on large cohorts.


OBJECTIVE
To evaluate the mortality and major morbidities among VLBW infants with EOS.


METHODS
This was a population-based observational study. Data were prospectively collected by the Israel Neonatal Network on all VLBW infants born in Israel from 1995 through 2005. Univariate and multivariable analyses were performed to assess the independent association of EOS on morbidity and mortality of VLBW infants.


RESULTS
The study cohort included 15 839 infants, of whom 383 (2.4%) developed EOS. EOS was associated with significantly increased odds for mortality (odds ratio [OR]: 2.57 [95% confidence interval (CI): 1.97-3.35]), severe intraventricular hemorrhage (OR: 2.24 [95% CI: 1.67-3.00]), severe retinopathy of prematurity (OR: 2.04 [95% CI: 1.32-3.16]), and bronchopulmonary dysplasia (OR: 1.74 [95% CI: 1.24-2.43]). EOS was associated with an increased risk of death and/or severe neurologic morbidity (OR: 2.92 [95% CI: 2.27-3.80]).


CONCLUSIONS
Although only 2.4% of VLBW infants had an episode of EOS, these infants were at an approximately threefold excess risk of death or major neurologic morbidities.
Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tiqva 49202, Israel. gilkl@post.tau.ac.il
Gil
G
Klinger
Itzhak
I
Levy
Lea
L
Sirota
Valentina
V
Boyko
Liat
L
Lerner-Geva
Brian
B
Reichman
D017668:Age of Onset; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D019102:Infant, Very Low Birth Weight; D007557:Israel / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016896:Treatment Outcome