Late-onset bloodstream infections in preterm infants: a 2-year survey.
BACKGROUND
We determined the prevalence and risk factors for late-onset bloodstream infections (LO-BSI), the distribution of pathogens and the outcomes of affected preterm infants.


METHODS
The records of all preterm infants (<37 weeks gestation) born between 2004 and 2005 and hospitalized in the neonatal intensive care unit for >3 days were retrieved for this retrospective matched case-control study.


RESULTS
A total of 108 out of 1459 preterm infants (7.4%) had 142 episodes of LO-BSI. The highest LO-BSI rate (44%) was among 198 very-low-birthweight infants (<1500 g). The most common causative organisms were Coagulase-negative staphylococci and Klebsiella (60% and 13%, respectively). The mean hospital stay was 64 days for LO-BSI preterm infants versus 48 days for non-LO-BSI preterm infants. Congenital malformations and peripheral catheters were independent risk factors for LO-BSI. Crude mortality rates were 6.9% (LO-BSI) and 3.0% (non-LO-BSI), with an LO-BSI-attributable mortality of 3.9%.


CONCLUSIONS
LO-BSI frequently affect very-low-birthweight infants. Strategies to prevent LO-BSI should target peripheral catheters.
Pediatric Infectious Diseases Service, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. galiag@post.tau.ac.il
Galia
G
Grisaru-Soen
Tal
T
Friedman
Shaul
S
Dollberg
Hagit
H
Mishali
Yehuda
Y
Carmeli
D017668:Age of Onset; D016470:Bacteremia / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors