The prognostic value of NIRS in preterm infants with (suspected) late-onset sepsis in relation to long term outcome: A pilot study

PLoS One. 2019 Jul 24;14(7):e0220044. doi: 10.1371/journal.pone.0220044. eCollection 2019.

Abstract

Late-onset sepsis is frequently seen in preterm infants and is associated with poor neurodevelopmental outcome. White matter damage is proposed as substrate of poor outcome, with contributing factors as regional hypoxia and effects of cytokines on oligodendrocytes. We investigated the relation between cerebral oxygenation during (suspected) late-onset sepsis and neurodevelopmental outcome. Prospective cohort study, including preterm infants (gestational age <32 weeks and/or birthweight <1500 grams) with (suspected) late-onset sepsis underwent NIRS registration during the first 72 hours of suspected late-onset sepsis. At two years corrected age neurodevelopment was scored using the Bayley Scales of Infant Development-II. Thirty-two infants were included. Twenty-seven infants were identified with proven late-onset sepsis and five infants had clinical sepsis without positive blood culture. In this study, late-onset sepsis was predominantly caused by coagulase negative staphylococci (CoNS) (72%). All NIRS values were within normal limits. No association was found between NIRS and impaired neurodevelopmental outcome (n = 4) at corrected age two years: composite cognitive score 105 (80-115), composite motor score 103 (82-118) (median and range). In this pilot study, late-onset sepsis (predominantly caused by CoNS with a relatively mild clinical course), was not associated with aberrant NIRS values, nor with impaired neurodevelopmental outcome. Further research might establish our findings and elucidate effects of other micro-organisms on cerebral perfusion.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development
  • Developmental Disabilities / epidemiology*
  • Female
  • Humans
  • Infant, Newborn*
  • Infant, Premature*
  • Male
  • Neonatal Sepsis / diagnostic imaging*
  • Neonatal Sepsis / epidemiology
  • Neonatal Sepsis / microbiology
  • Pilot Projects
  • Predictive Value of Tests
  • Spectroscopy, Near-Infrared / methods
  • Spectroscopy, Near-Infrared / standards*
  • Staphylococcal Infections / diagnostic imaging
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology

Grants and funding

This work was supported by grants from Fonds Nuts Ohra (grant numbers 0901-042 and 1101-093), http://www.fondsnutsohra.nl/. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.