title: Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition.
abstract: BACKGROUND
  The purpose of this study was to establish the late onset sepsis (LOS) rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN).
  
  
  METHODS
  Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC) tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip.
  
  
  RESULTS
  74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4%) infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2%) and blood (67.8%). All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation.
  
  
  CONCLUSIONS
  In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil.
authors.forename: Priscila Castro Cordeiro
authors.initials: PC
authors.lastname: Fernandes
authors.forename: Elias Jose Oliveira von
authors.initials: EJ
authors.lastname: Dolinger
authors.forename: Vânia Olivetti Steffen
authors.initials: VO
authors.lastname: Abdallah
authors.forename: Daiane Silva
authors.initials: DS
authors.lastname: Resende
authors.forename: Paulo Pinto
authors.initials: PP
authors.lastname: Gontijo Filho
authors.forename: Denise von Dolinger de
authors.initials: Dv
authors.lastname: Brito
mesh_terms: D018988:Bacterial Translocation; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007422:Intestines / Q000382:microbiology*; D010288:Parenteral Nutrition / Q000009:adverse effects*; D018805:Sepsis / Q000209:etiology*; D013997:Time Factors