Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA.
J Pediatr. 2013 Jun;162(6):1120-4, 1124.e1. doi: 10.1016/j.jpeds.2012.11.089. Epub 2013 Jan 13.
To describe and compare the incidence of late-onset sepsis (LOS) and demographic and clinical characteristics associated with LOS in very low birth weight (VLBW) infants from singleton and multiple births, and to examine the heritability of susceptibility to LOS among VLBW twins by comparing same-sex and unlike-sex twin pairs.
The study group comprised infants with birth weight 401-1500 g seen at clinical centers of the Eunice Kennedy Shriver National Institute of Child and Human Development Neonatal Research Network between 2002 and 2008. Only the first episode of LOS was included in our analysis. Stepwise logistic regression models were fitted separately for singleton and multiple pregnancies to examine the maternal and neonatal factors associated with LOS. LOS due solely to gram-negative bacteria in singleton and multiple pregnancies was also examined in separate models. The heritability of LOS was estimated by examining the concordance of LOS in twins from same-sex and unlike-sex pairs.
LOS occurred in 25.0% (3797 of 15,178) of singleton and 22.6% (1196 of 5294) of multiple-birth VLBW infants. Coagulase-negative staphylococci were the most common infecting organisms, accounting for 53.2% of all LOS episodes in singletons and 49.2% in multiples. Escherichia coli and Klebsiella species were the most commonly isolated gram-negative organisms, and Candida albicans was the most commonly isolated fungus. Concordance of LOS did not differ significantly between same-sex and unlike-sex twin pairs.
LOS remains a common problem in VLBW infants. The incidence of LOS is similar for singleton and multiple-birth infants. The similar concordance of LOS in same-sex and unlike-sex twin pairs provides no evidence that susceptibility to LOS among VLBW infants is genetically determined.
描述和比较极低出生体重儿（VLBW）中来自单胎和多胎的晚发性败血症（LOS）的发生率以及与 LOS 相关的人口统计学和临床特征，并通过比较同性别和非同性别双胞胎对来检查 VLBW 双胞胎对 LOS 易感性的遗传性。
研究组包括 2002 年至 2008 年在 Eunice Kennedy Shriver 国立儿童和人类发展研究所新生儿研究网络的临床中心就诊的体重为 401-1500g 的婴儿。我们的分析仅包括 LOS 的首次发作。分别为单胎和多胎妊娠建立逐步逻辑回归模型，以检查与 LOS 相关的母亲和新生儿因素。还在单独的模型中检查了单胎和多胎妊娠中仅因革兰氏阴性菌引起的 LOS。通过检查同性别和非同性别双胞胎对 LOS 的一致性来估计 LOS 的遗传性。
LOS 发生在 25.0%（3797 例 15178 例）的单胎和 22.6%（1196 例 5294 例）的多胎 VLBW 婴儿中。凝固酶阴性葡萄球菌是最常见的感染菌，占单胎 LOS 发作的 53.2%，占多胎的 49.2%。大肠杆菌和克雷伯氏菌属是最常见的分离革兰氏阴性菌，白假丝酵母是最常见的分离真菌。同性别和非同性别双胞胎对 LOS 的一致性无显著差异。
LOS 仍然是 VLBW 婴儿的常见问题。单胎和多胎婴儿的 LOS 发生率相似。同性别和非同性别双胞胎对 LOS 的一致性相似，这表明 VLBW 婴儿对 LOS 的易感性不是由遗传决定的。
