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J Perinatol. 2004 Mar;24(3):175-80.

Mortality following blood culture in premature infants: increased with Gram-negative bacteremia and candidemia, but not Gram-positive bacteremia.

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  • 1Duke Clinical Research Institute, Durham, NC 27715, USA.

Abstract

OBJECTIVE:

To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture.

STUDY DESIGN:

Multicenter cohort study of premature infants.

RESULTS:

First blood culture was negative for 4648/5497 (78%) of the neonates--390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR)=2.61] and candidemia (HR=2.27) were associated with increased mortality; CONS (HR=1.08) and GP-o (HR=0.97) were not.

CONCLUSIONS:

Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Gram-positive bacteremia was not.

PMID:
14985775
[PubMed - indexed for MEDLINE]
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