Characteristics | Neonatal BSIs with specific focus of infection (total n = 167) | Primary bacteremia (n = 781) | ||||
---|---|---|---|---|---|---|
Meningitis (n = 51) | VAP (n = 36) | CLABSI (n = 57) | NEC (n = 21) | Othersb (n = 7) | ||
Demographic characteristics | ||||||
Birth body weight (g), median (IQR) | 2375 (1405–2905)** | 960 (820–1600)** | 1267.5 (911–2680) | 1480 (1065–2040)* | 2330 (1600–2700)* | 1240 (880–1880) |
Gestational age (weeks), median (IQR) | 35.0 (30.0–38.0)** | 27.0 (25.0–31.0)** | 29.5 (27.0–37.0) | 29.0 (27.0–34.0) | 37.0 (32–38)** | 30.0 (27.0–34.0) |
Male sex, n (%) | 30 (58.8) | 21 (58.3) | 29 (50.9) | 10 (47.6) | 5 (71.4) | 405 (51.9) |
Onset of BSI (day), median (IQR) | 33.5 (17.8–60.3) | 30 (20–58)* | 25 (17–45.5) | 19 (12–43)** | 42 (11–73) | 28 (17.0–53.0) |
Perinatal history | ||||||
Low Apgar score at 5 min (≦ 7) | 13 (25.5)** | 22 (61.1)** | 26 (45.6) | 5 (23.8)** | 2 (28.6)** | 351 (44.9) |
Perinatal asphyxia | 6 (11.8) | 13 (36.1)** | 4 (7.0) | 2 (9.5) | 0 (0) | 62 (7.9) |
Underlying chronic conditionsa | ||||||
Congenital anomalies | 2 (3.9) | 2 (5.6) | 4 (7.0) | 0 (0) | 2 (28.6) | 55 (7.0) |
Neurological comorbidities | 23 (45.1)** | 5 (13.9) | 3 (5.3) | 1 (4.8) | 1 (14.3) | 91 (11.7) |
Complicated congenital heart disease | 0 (0) | 0 (0) | 3 (5.3) | 0 (0) | 0 (0) | 32 (4.1) |
Acyanotic CHD with heart failure | 0 (0) | 1 (2.8) | 3 (5.3) | 0 (0) | 0 (0) | 17 (2.2) |
Bronchopulmonary dysplasia | 9 (17.6) | 23 (63.9)** | 15 (26.3) | 6 (28.6) | 2 (28.6) | 243 (31.1) |
Pulmonary hypertension | 1 (2.0) | 1 (2.8) | 3 (5.3) | 0 (0) | 0 (0) | 23 (2.9) |
Gastrointestinal pathology | 0 (0) | 1 (2.8) | 4 (7.0) | 3 (14.3) | 0 (0) | 54 (6.9) |
Renal | 1 (2.0) | 1 (2.8) | 2 (3.5) | 1 (4.8) | 0 (0) | 25 (3.2) |
Cholestasisb | 4 (7.8) | 9 (25.0) | 13 (22.8) | 6 (28.6) | 4 (57.1)** | 147 (18.8) |
Clinical septic symptoms | ||||||
Fever (temperature > 38 °C) | 33 (64.7) | 8 (22.2) | 26 (45.6) | 6 (28.6) | 4 (57.1) | 319 (40.8) |
Apnea ± bradycardia and/or cyanosis | 31 (60.8) | 32 (88.9) | 40 (70.2) | 16 (76.2) | 5 (71.4) | 528 (67.6) |
Abdominal distension ± feeding intolerance | 31 (60.8) | 27 (75.0)* | 27 (47.4) | 21 (100)** | 5 (71.4)* | 457 (58.5) |
Tachycardia | 15 (29.4) | 5 (13.9) | 13 (22.8) | 6 (28.6) | 1 (14.3) | 177 (22.7) |
Hyper- or hypoglycemia | 14 (27.5) | 14 (38.9) | 11 (19.3) | 8 (38.1) | 1 (14.3) | 206 (26.4) |
Septic shock | 8 (15.7) | 11 (30.6)* | 6 (10.5) | 9 (42.9)** | 2 (28.6) | 126 (16.1) |
Disseminated intravascular coagulopathy | 8 (15.7)* | 5 (13.9) | 3 (5.3) | 5 (23.8)* | 1 (14.3) | 62 (7.9) |
Laboratory parameter | ||||||
Leukopenia (WBC count <4000/uL) | 12 (23.5) | 6 (16.7) | 5 (8.8) | 9 (42.9)** | 3 (42.9)** | 127 (16.3) |
Leukocytosis (WBC count >20,000/uL) | 14 (27.5) | 14 (38.9)* | 13 (22.8) | 5 (23.8) | 4 (57.1)** | 217 (27.8) |
WBC shift to left (immature WBC ≥ 20%) | 10 (19.6) | 7 (19.4) | 3 (5.3) | 7 (33.3)** | 1 (14.3) | 89 (11.4) |
Anemia (hemoglobin <11.0 mg/dL) | 22 (43.1) | 23 (63.9)** | 26 (45.6) | 13 (61.9)** | 2 (28.6) | 291 (37.3) |
Thrombocytopenia (platelet <80,000/uL) | 16 (31.4) | 21 (58.3)** | 19 (33.3) | 11 (52.4)** | 1 (14.3) | 267 (34.2) |
Metabolic acidosis | 12 (23.5) | 15 (41.7)** | 6 (11.8) | 10 (47.7)** | 1 (14.3) | 139 (17.8) |
Prolonged PT and/or aPTT | 12 (23.5) | 11 (30.5) | 12 (21.1) | 11 (52.4)** | 1 (14.3) | 196 (25.1) |
Sequences of BSI during hospitalization | ||||||
1st episode | 41 (80.4) | 27 (75.0) | 42 (73.7) | 19 (90.5) | 4 (57.1) | 584 (74.8) |
2nd episode | 7 (13.7) | 6 (16.7) | 12 (21.1) | 1 (4.8) | 2 (28.6) | 126 (16.1) |
3rd (or greater) episode | 3 (5.9) | 3 (8.3) | 3 (5.3) | 1 (4.8) | 1 (14.3) | 71 (9.1) |