title: Late-onset sepsis in very low birth weight infants from singleton and multiple-gestation births.
abstract: OBJECTIVE
  To describe and compare the incidence of late-onset sepsis (LOS) and demographic and clinical characteristics associated with LOS in very low birth weight (VLBW) infants from singleton and multiple births, and to examine the heritability of susceptibility to LOS among VLBW twins by comparing same-sex and unlike-sex twin pairs.
  
  
  METHODS
  The study group comprised infants with birth weight 401-1500 g seen at clinical centers of the Eunice Kennedy Shriver National Institute of Child and Human Development Neonatal Research Network between 2002 and 2008. Only the first episode of LOS was included in our analysis. Stepwise logistic regression models were fitted separately for singleton and multiple pregnancies to examine the maternal and neonatal factors associated with LOS. LOS due solely to gram-negative bacteria in singleton and multiple pregnancies was also examined in separate models. The heritability of LOS was estimated by examining the concordance of LOS in twins from same-sex and unlike-sex pairs.
  
  
  RESULTS
  LOS occurred in 25.0% (3797 of 15,178) of singleton and 22.6% (1196 of 5294) of multiple-birth VLBW infants. Coagulase-negative staphylococci were the most common infecting organisms, accounting for 53.2% of all LOS episodes in singletons and 49.2% in multiples. Escherichia coli and Klebsiella species were the most commonly isolated gram-negative organisms, and Candida albicans was the most commonly isolated fungus. Concordance of LOS did not differ significantly between same-sex and unlike-sex twin pairs.
  
  
  CONCLUSIONS
  LOS remains a common problem in VLBW infants. The incidence of LOS is similar for singleton and multiple-birth infants. The similar concordance of LOS in same-sex and unlike-sex twin pairs provides no evidence that susceptibility to LOS among VLBW infants is genetically determined.
authors: Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA.
authors: Nansi S
authors: NS
authors: Boghossian
authors: Grier P
authors: GP
authors: Page
authors: Edward F
authors: EF
authors: Bell
authors: Barbara J
authors: BJ
authors: Stoll
authors: Jeffrey C
authors: JC
authors: Murray
authors: C Michael
authors: CM
authors: Cotten
authors: Seetha
authors: S
authors: Shankaran
authors: Michele C
authors: MC
authors: Walsh
authors: Abbot R
authors: AR
authors: Laptook
authors: Nancy S
authors: NS
authors: Newman
authors: Ellen C
authors: EC
authors: Hale
authors: Scott A
authors: SA
authors: McDonald
authors: Abhik
authors: A
authors: Das
authors: Rosemary D
authors: RD
authors: Higgins
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000382:microbiology; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D009099:Multiple Birth Offspring; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology