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J Pediatr. 2012 Jan;160(1):54-9.e2. doi: 10.1016/j.jpeds.2011.06.034. Epub 2011 Aug 15.

Bloodstream infections in very low birth weight infants with intestinal failure.

Collaborators (166)

Jobe AH, Caplan MS, Oh W, Laptook AR, Vohr BR, Stephens BE, Hensman AM, Watson V, Leach TM, Ventura S, Fanaroff AA, Walsh MC, Wilson-Costello D, Newman NS, Siner BS, Schibler K, Donovan EF, Steichen J, Yolton K, Bridges K, Alexander B, Grisby C, Mersmann M, Mincey HL, Shively J, Gratton TL, Goldberg RN, Michael Cotten C, Goldstein R, Auten KJ, Fisher KA, Lohmeyer MB, Stoll BJ, Carlton DP, Adams-Chapman I, Hale EC, Higgins RD, Wright LL, McClure EM, Stephanie WA, Poindexter BB, Lemons JA, Dusick AM, Herron DE, Miller LC, Das A, Kenneth Poole W, O'Donnell Auman J, Cunningham M, Hastings BK, McClure EM, Petrie Huitema CM, Pickett JW, Schaefer SE, Zaterka Baxter KM, Van Meurs KP, Stevenson DK, Hintz SR, Bethany Ball M, Fleisher BE, De-Battista AM, Baran JM, Bond LE, Bentley B, Brudos GK, Pyle RP, St John NH, Carlo WA, Ambalavanan N, Dimmitt R, Peralta-Carcelen M, Collins MV, Cosby SS, Phillips V, Finer NN, Kaegi D, Rasmussen MR, Vaucher YE, Wozniak PR, Arnell K, Demetrio C, Fuller MG, Henderson C, Rich W, Bauer CR, Duara S, Everett-Thomas R, Hamlin-Smith K, Hiriart-Fajardo S, Frade Eguaras SM, Gideon YC, Mathews EO, Diaz AN, Garcia A, Phelps DL, Myers G, Reubens LJ, Burnell E, Jensen R, Hust D, Rowan M, Yost K, Lauren Zwetsch P, Merzbach J, Kushner E, Sanchez PJ, Laptook AR, Rosenfeld CR, Salhab WA, Sue Broyles R, Heyne RJ, Hensley G, Hickman JF, Madison S, Miller NA, Morgan JS, Guzman A, Heyne E, Madden LA, Adams S, Dooley C, Boatman C, Tyson JE, Kennedy KA, Bradt PJ, Evans P, Major-Kincade T, Morris BH, Whitely LL, Alaniz NI, Akpa EG, Cedillo M, Cluff PA, Dieterich S, Franco CI, Green C, Lis AE, McDavid GE, Reddoch S, Simmons MC, Pierce Tate PL, Wright SL, O'Shea T, Dillard RG, Washburn LK, Goldstein CD, Jackson BG, Peters NJ, Peterson C, Waldrep EL, Whalen Morris M, Hounshell GW, Shankaran S, Johnson YR, Pappas A, Bara R, Muran G, Kennedy D, Goldston LA, Ehrenkranz RA, Gettner P, Konstantino M, Poulsen J, Romano E, Taft J, Williams J.

Author information

1
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. conrad.cole@cchmc.org

Abstract

OBJECTIVE:

To examine pathogens and other characteristics associated with late-onset bloodstream infections (BSIs) in infants with intestinal failure (IF) as a consequence of necrotizing enterocolitis (NEC).

STUDY DESIGN:

Infants weighing 401-1500 g at birth who survived for >72 hours and received care at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers were studied. The frequency of culture-positive BSI and pathogens were compared in infants with medically managed NEC, NEC managed surgically without IF, and surgical IF. Among infants with IF, the duration of parenteral nutrition (PN) and other outcomes were evaluated.

RESULTS:

A total of 932 infants were studied (IF, n = 78; surgical NEC without IF, n = 452; medical NEC, n = 402). The proportion with BSI after diagnosis of NEC was higher in the infants with IF than in those with surgical NEC (P = .007) or medical NEC (P < .001). Gram-positive pathogens were most frequent. Among infants with IF, an increased number of infections was associated with longer hospitalization and duration of PN (median stay: 172 for those with 0 infections, 188 days for those with 1 infection, and 260 days for those with ≥2 infections [P = .06]; median duration of PN: 90, 112, and 115 days, respectively [P = .003]) and decreased achievement of full feeds during hospitalization (87%, 67%, and 50%, respectively; P = .03).

CONCLUSION:

Recurrent BSIs are common in very low birth weight infants with IF. Gram-positive bacteria were the most commonly identified organisms in these infants.

PMID:
21840538
PMCID:
PMC3419271
DOI:
10.1016/j.jpeds.2011.06.034
[Indexed for MEDLINE]
Free PMC Article
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