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Morbidity and mortality of coagulase-negative staphylococcal sepsis in very-low-birth-weight infants

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Abstract

Background

Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality.

Methods

This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h. CoNS was considered a pathogen if recovered from ≥ 2 cultures, or 1 culture if treated for ≥ 5 days and signs of sepsis were present. Logistic regression was used to examine factors associated with morbidity and mortality.

Results

Of 2242 VLBW infants, 285 (12.7%) had late-onset sepsis. CoNS (125, 44%), Staphylococcus aureus (52, 18%), and Escherichia coli (36, 13%) were the most commonly recovered organisms. In multivariate analysis, CoNS sepsis was not associated with mortality [OR 0.6 (95% CI 0.2–2.6)), but sepsis with other organisms was [OR 4.5 (95% CI 2.6–8.0)]. CoNS sepsis was associated with longer hospitalization but not risk for bronchopulmonary dysplasia, intraventricular hemorrhage, or retinopathy of prematurity.

Conclusion

CoNS sepsis was not associated with mortality or morbidities other than length of stay. These findings support vancomycin-reduction strategies in the NICU.

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Funding

No funding was secured for this manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Joseph B. Cantey

  2. Texas A&M Health Science Center College of Medicine, Bryan, TX, USA

    Kelsey R. Anderson

  3. Texas A&M Health Science Center, Baylor/Scott & White Health, Temple, TX, USA

    Ram R. Kalagiri & Lea H. Mallett

Authors
  1. Joseph B. Cantey
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  2. Kelsey R. Anderson
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  3. Ram R. Kalagiri
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  4. Lea H. Mallett
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Contributions

JBC conceptualized and designed the study, collected data, wrote the first draft of the manuscript, and approved the final version. KRA collected data, assisted with revisions, and approved the final version. RRK helped conceptualize the study, collected data, assisted with revisions, and approved the final version. LHM helped conceptualize and design the study, analyzed the data, assisted with revisions, and approved the final version.

Corresponding author

Correspondence to Joseph B. Cantey.

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Ethical approval

This study was approved by the Institutional Review Board of Baylor Scott & White Health.

Conflcit of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Cite this article

Cantey, J.B., Anderson, K.R., Kalagiri, R.R. et al. Morbidity and mortality of coagulase-negative staphylococcal sepsis in very-low-birth-weight infants. World J Pediatr 14, 269–273 (2018). https://doi.org/10.1007/s12519-018-0145-7

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  • DOI: https://doi.org/10.1007/s12519-018-0145-7

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