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Neonatal sepsis and Kawasaki disease

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Abstract

The purpose of this study is to clarify the relationship between neonatal sepsis and future development of Kawasaki disease (KD). We analyzed data from the National Hospital Organization Neonatal Intensive Care Unit (NHO-NICU) registry study in Japan. Participants in this study were children with a history of hospitalization in the NICU at the participating institutions from 2010 to 2014. A questionnaire was administered at age 3 years to obtain information about the patient’s history of KD. There were 8275 infants who were eligible for this study. At 3 years of age, parents of 2161 children responded to the follow-up survey (follow-up rate, 26.1%). Multivariate logistic regression analysis adjusted for preterm birth, sex, use of antibiotics in the NICU, parity, and maternal smoking showed that children with neonatal sepsis were more likely to have a history of KD at 3 years of age (adjusted odds ratio [aOR]: 11.67, 95% confidence interval [CI]: 2.84–47.96).

Conclusions: Among infants admitted to the NICU, neonatal sepsis might be associated with development of KD later in life. Further large studies are needed to elucidate the relationship between neonatal infections and KD development.

What is Known:

• Preterm birth is known to be a risk factor for Kawasaki disease.

•It is not yet known which factors related to preterm birth increase the risk of developing Kawasaki disease.

What is New:

•Neonatal sepsis is associated with an increased risk of subsequent development of Kawasaki disease.

•Antibiotic use in the neonatal intensive care unit may also be an independent risk factor for subsequent development of Kawasaki disease.

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Abbreviations

AGA:

Appropriate for gestational age

EOS:

Early onset sepsis

KD:

Kawasaki disease

LOS:

Late onset sepsis

NICU:

Neonatal intensive care unit

SGA:

Small for gestational age

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Acknowledgements

The authors have no financial relationships relevant to this article to disclose. We thank Dr. Toshinori Nakashima, Dr. Toru Kuboi, Dr. Kou Kawada, Dr. Kazuhiro Takahashi, Dr. Kazuo Sato, Dr. Hiroshi Koga, Dr. Tsuneo Igarashi, Dr. Toshimitsu Takayanagi, Dr. Motohiro Inotani, and Dr. Yasuhiko Sera who are members of the NHO-NICU registry group.

Funding

This work was supported by a National Hospital Organization Network Study Grant (2–09, H27 NHO seiiku-02).

Author information

Authors and Affiliations

  1. Division of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan

    Akihito Takeuchi, Kei Tamai, Kazue Nakamura, Makoto Nakamura & Misao Kageyama

  2. Division of Neonatology, Mie Chuo Medical Center, National Hospital Organization, Mie, Japan

    Noriko Sugino & Motoki Bonno

  3. Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan

    Takahiro Namba

  4. Department of Epidemiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan

    Takashi Yorifuji

Authors
  1. Akihito Takeuchi
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  2. Noriko Sugino
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  3. Takahiro Namba
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  4. Kei Tamai
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  5. Kazue Nakamura
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  6. Makoto Nakamura
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  7. Misao Kageyama
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  8. Takashi Yorifuji
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  9. Motoki Bonno
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Contributions

Dr. Takeuchi conceptualized and designed this study, performed the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. Drs. Sugino and Bonno planned and executed the NHO-NICU registry study, conceptualized and designed this study, and reviewed and revised the manuscript. Drs. Namba, Tamai, Nakamura M, Nakamura K, and Kageyama and Prof. Yorifuji conceptualized and designed this study and reviewed and revised the manuscript. All authors had full access to all the data in this study, and they accept responsibility to submit it for publication.

Corresponding author

Correspondence to Akihito Takeuchi.

Ethics declarations

Ethics approval

This study was conducted in accordance with the principles of the Declaration of Helsinki. This study was approved by the Central Ethics Committee of the NHO (2–09, H27-NHO seiiku-02).

Consent to participate

Written informed consent was obtained from the participants’ parents.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Daniele De Luca.

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Cite this article

Takeuchi, A., Sugino, N., Namba, T. et al. Neonatal sepsis and Kawasaki disease. Eur J Pediatr 181, 2927–2933 (2022). https://doi.org/10.1007/s00431-022-04501-z

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  • DOI: https://doi.org/10.1007/s00431-022-04501-z

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