Morbidity and mortality of coagulase-negative staphylococcal sepsis in very-low-birth-weight infants
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Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality.
This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h. CoNS was considered a pathogen if recovered from ≥ 2 cultures, or 1 culture if treated for ≥ 5 days and signs of sepsis were present. Logistic regression was used to examine factors associated with morbidity and mortality.
Of 2242 VLBW infants, 285 (12.7%) had late-onset sepsis. CoNS (125, 44%), Staphylococcus aureus (52, 18%), and Escherichia coli (36, 13%) were the most commonly recovered organisms. In multivariate analysis, CoNS sepsis was not associated with mortality [OR 0.6 (95% CI 0.2–2.6)), but sepsis with other organisms was [OR 4.5 (95% CI 2.6–8.0)]. CoNS sepsis was associated with longer hospitalization but not risk for bronchopulmonary dysplasia, intraventricular hemorrhage, or retinopathy of prematurity.
CoNS sepsis was not associated with mortality or morbidities other than length of stay. These findings support vancomycin-reduction strategies in the NICU.
KeywordsMorbidity Mortality Neonate Sepsis
JBC conceptualized and designed the study, collected data, wrote the first draft of the manuscript, and approved the final version. KRA collected data, assisted with revisions, and approved the final version. RRK helped conceptualize the study, collected data, assisted with revisions, and approved the final version. LHM helped conceptualize and design the study, analyzed the data, assisted with revisions, and approved the final version.
Compliance with ethical standards
This study was approved by the Institutional Review Board of Baylor Scott & White Health.
Conflcit of interest
No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
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