title: Late-onset sepsis in very low birth weight infants: a Brazilian Neonatal Research Network Study.
abstract: BACKGROUND
  Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.
  
  
  OBJECTIVE
  To determine the incidence, risk factors and etiology of LOS.
  
  
  METHODS
  LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.
  
  
  RESULTS
  Of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. The majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.
  
  
  CONCLUSIONS
  LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.
authors: Department of Pediatrics, Botucatu School of Medicine, Sao Paulo State University-UNESP, Botucatu, SP, Brazil ligiasr@fmb.unesp.br.
authors: Ligia Maria Suppo
authors: LM
authors: de Souza Rugolo
authors: Department of Pediatrics, Botucatu School of Medicine, Sao Paulo State University-UNESP, Botucatu, SP, Brazil.
authors: Maria Regina
authors: MR
authors: Bentlin
authors: Department of Pediatrics, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors: Marisa
authors: M
authors: Mussi-Pinhata
authors: Division of Neonatal Medicine, Universidade Federal de São Paulo, SP, Brazil.
authors: Maria Fernanda Branco
authors: MF
authors: de Almeida
authors: Neonatal Department, Fernandes Figueira Institute of Oswaldo Cruz Foundation, RJ, Brazil.
authors: José Maria de Andrade
authors: JM
authors: Lopes
authors: Department of Pediatrics, State University of Campinas, Campinas, SP, Brazil.
authors: Sergio Tadeu Martins
authors: ST
authors: Marba
authors: Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Humberto Holmer
authors: HH
authors: Fiori
authors: Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Renato Soibelmann
authors: RS
authors: Procianoy
authors: Department of Pediatrics, University of São Paulo, SP, Brazil.
authors: Clea Rodrigues
authors: CR
authors: Leone
mesh_terms: D017668:Age of Onset; D001938:Brazil / Q000453:epidemiology; D020314:Central Nervous System Fungal Infections / Q000097:blood / Q000401:mortality; D002648:Child; D005260:Female; D005865:Gestational Age; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000382:microbiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000382:microbiology*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood / Q000382:microbiology / Q000401:mortality*
keywords: Sepsis; infection; newborn infant; premature; very low birth weight