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A retrospective study (2001–2017) of acute and chronic morbidity and mortality associated with Staphylococcus aureus bacteraemia in a tertiary neonatal intensive care unit

  • Daniel O’ReillyEmail author
  • Ciara O’Connor
  • Naomi McCallion
  • Richard J. Drew
Original Article
  • 122 Downloads

Abstract

Background

Staphylococcus aureus bacteraemia (SAB) in NICU patients can cause significant morbidity and mortality.

Aims

To review early and late neonatal SAB with regard to risk factors, treatment, acute complications and long-term outcomes.

Methods

A retrospective study of laboratory confirmed SAB over a 16-year period (November 2001–January 2017) in a tertiary neonatal unit in Ireland.

Findings

A total of 74 neonates (MSSA n = 72, MRSA n = 2) were identified; 8.1% (n = 6) early sepsis, 91.8% (n = 68) late sepsis. Low birth weight neonates (born weighing less than 2500 g) 80% (n = 59). Median age to bacteraemia 11 days post-delivery (range = 0–100 days); median onset early sepsis 1.5 days versus late sepsis 12 days. Complications of SAB; cellulitis n = 17, pneumonia n = 12, necrotising enterocolitis n = 7, thromobophlebitis n = 5, skin abscess formation n = 4, osteomyelitis n = 3, endocarditis n = 1. Late SAB mortality 6.4% (n = 3).

Conclusions

Preterm and low birth weight infants were at highest risk of SAB. Only a small proportion of affected children had long-term clinical sequelae on follow-up. The high rate of recurrence and breakthrough bacteraemia suggests that early implementation of a targeted anti-staphylococcal antimicrobial regimen may be of particular benefit.

Keywords

Neonatal intensive care unit Outcomes Staphylococcus aureus bloodstream infection 

Notes

Compliance with ethical standards

Ethical approval was received from the local ethics committee to conduct this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Royal Academy of Medicine in Ireland 2019

Authors and Affiliations

  1. 1.Department of NeonatologyRotunda HospitalDublin 1Ireland
  2. 2.Department of Clinical MicrobiologyTemple Street Children’s University HospitalDublin 1Ireland
  3. 3.Department of PaediatricsRoyal College of Surgeons in IrelandDublin 2Ireland
  4. 4.Clinical Innovation UnitRotunda HospitalDublin 1Ireland
  5. 5.Department of MicrobiologyRoyal College of Surgeons in IrelandDublin 2Ireland
  6. 6.Irish Meningitis and Sepsis Reference Laboratory (IMSRL)Temple Street Children’s University HospitalDublin 1Ireland

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