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Late-onset sepsis among extremely preterm infants of 24-28 weeks gestation : an international comparison in 10 high-income countries

Klinger, Gil (author)
Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; School of Medicine, Tel Aviv University, Tel Aviv, Israel
Reichman, Brian (author)
School of Medicine, Tel Aviv University, Tel Aviv, Israel; Women and Children's Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel
Norman, Mikael (author)
Karolinska Institutet, Department of Clinical Science, Intervention, and Technology, Stockholm, Sweden; Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
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Kusuda, Satoshi (author)
Department of Pediatrics, Kyorin University, Tokyo, Japan
Battin, Malcolm (author)
Newborn Service, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
Helenius, Kjell (author)
Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Medicine, University of Turku, Turku, Finland
Isayama, Tetsuya (author)
Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
Lui, Kei (author)
Department of Newborn Care, Royal Hospital for Women and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, NSW, Sydney, Australia
Adams, Mark (author)
Newborn Research, Department of Neonatology, University of Zurich, University Hospital Zurich, Zurich, Switzerland
Vento, Maximo (author)
Instituto de Investigación Sanitaria (Health Research Institute) La Fe Valencia, Valencia, Spain
Håkansson, Stellan (author)
Umeå universitet,Pediatrik
Beltempo, Marc (author)
Department of Pediatrics, McGill University, QC, Montreal, Canada
Poggi, Chiara (author)
Neonatal Intensive Care Unit, Department of Mother and Child Care, Careggi University Hospital, Florence, Italy
San Feliciano, Laura (author)
Unidad de Neonatología, Hospital Universitario de Salamanca, Salamanca, Spain
Lehtonen, Liisa (author)
Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Medicine, University of Turku, Turku, Finland
Bassler, Dirk (author)
Department of Newborn Care, Royal Hospital for Women and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, NSW, Sydney, Australia
Yang, Junmin (author)
Department of Pediatrics, Mount Sinai Hospital, University of Toronto, ON, Toronto, Canada
Shah, Prakesh S. (author)
Department of Pediatrics, Mount Sinai Hospital, University of Toronto, ON, Toronto, Canada
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 (creator_code:org_t)
2024
2024
English.
In: Neonatology. - : S. Karger. - 1661-7800 .- 1661-7819.
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Introduction: Despite advances in neonatal care, late-onset sepsis remains an important cause of preventable morbidity and mortality. Neonatal late-onset sepsis rates have decreased in some countries, while in others they have not. Our objective was to compare trends in late-onset sepsis rates in 9 population-based networks from 10 countries and to assess the associated mortality within 7 days of late-onset sepsis.Methods: We performed a retrospective populationbased cohort study. Infants born at 24-28 weeks' gestation between 2007 and 2019 were eligible for inclusion. Lateonset sepsis was defined as a positive blood or cerebrospinal fluid culture. Late-onset sepsis rates were calculated for 3 epochs (2007-11, 2012-15, and 2016-19). Adjusted risk ratios (aRRs) for late-onset sepsis were calculated for each network.Results: Of a total of 82,850 infants, 16,914 (20.4%) had late-onset sepsis, with Japan having the lowest rate (7.1%) and Spain the highest (44.6%). Late-onset sepsis rates decreased in most networks and remained unchanged in a few. Israel, Sweden, and Finland showed the largest decrease in late-onset sepsis rates. The aRRs for late-onset sepsis showed wide variations between networks. The rate of mortality temporally related to late-onset sepsis was 10.9%. The adjusted mean length of stay for infants with late-onset sepsis was increased by 5-18 days compared to infants with no late-onset sepsis.Conclusions: One in 5 neonates of 24-28 weeks' gestation develops late-onset sepsis. Wide variability in late-onset sepsis rates exists between networks with most networks exhibiting improvement. Late-onset sepsis was associated with increased mortality and length of stay.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Keyword

Extremely preterm infants
Late-onset sepsis
Mortality
Trends

Publication and Content Type

ref (subject category)
art (subject category)

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