Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Krakow 31-121, Poland.
BMC Infect Dis. 2014 Jun 18;14:339. doi: 10.1186/1471-2334-14-339.
Late-Onset Bloodstream Infections (LO-BSI) continue to be one of the most important complications associated with hospitalization of infants born with very low birth weight (VLBW). The aims of this study were to assess the epidemiology of LO-BSI together with the risk factors and the distribution of causative pathogens at six Polish neonatal intensive care units that participated in the Polish Neonatology Surveillance Network from January 1, 2009 to December 31, 2011.
The surveillance covered 1,695 infants whose birth weights were <1501 grams (VLBW) in whom LO-BSI was diagnosed >72 hours after delivery. Case LO-BSI patients were defined according to NeoKISS.
Four hundred twenty seven episodes of LO-BSI were diagnosed with a frequency of 25.3% and an incidence density of 6.7/1000 patient-days (pds). Results of our multivariate analysis demonstrated that surgical procedures and lower gestational age were significantly associated with the risk of LO-BSI. Intravascular catheters were used in infants with LO-BSI significantly more frequently and/or for longer duration: Central venous cathters (CVC) (OR 1.29) and Peripheral venous catheters (PVC) (OR 2.8), as well as, the total duration of total parenteral nutrition (13 vs. 29 days; OR 1.81). Occurrence of LO-BSI was significantly associated with increased the length of mechanical ventilation (MV) (OR 2.65) or the continuous positive airway pressure (CPAP) (OR 2.51), as well as, the duration of antibiotic use (OR 2.98). The occurrence of more than one infection was observed frequently (OR 9.2) with VLBW with LO-BSI. Microorganisms isolated in infants with LO-BSI were dominated by Gram-positive cocci, and predominantly by coagulase-negative staphylococci (62.5%).
Independent risk factor for LO-BSI in VLBV infants are: low gestational age and requirement for surgery. The incidence rates of LO-BSI especially CVC-BSI were higher in the Polish NICUs surveillance than those of other national networks, similar to the central- and peripheral utilization ratio.
迟发性血流感染（LO-BSI）仍然是极低出生体重儿（VLBW）住院相关的最重要并发症之一。本研究的目的是评估 2009 年 1 月 1 日至 2011 年 12 月 31 日期间参加波兰新生儿监测网络的六家波兰新生儿重症监护病房的 LO-BSI 流行病学，以及危险因素和病原体分布。
该监测涵盖了 1695 名出生体重<1501 克（VLBW）的婴儿，这些婴儿在分娩后>72 小时被诊断为 LO-BSI。根据 NeoKISS 定义 LO-BSI 病例。
诊断出 427 例 LO-BSI，发病率为 25.3%，发病率密度为 6.7/1000 患者日（pds）。多变量分析结果表明，手术和较低的胎龄与 LO-BSI 的风险显著相关。患有 LO-BSI 的婴儿更频繁地使用血管内导管，或使用更长时间的血管内导管：中心静脉导管（CVC）（OR 1.29）和外周静脉导管（PVC）（OR 2.8），以及全胃肠外营养的总持续时间（13 天与 29 天；OR 1.81）。LO-BSI 的发生与机械通气（MV）（OR 2.65）或持续气道正压通气（CPAP）（OR 2.51）以及抗生素使用时间（OR 2.98）的延长显著相关。观察到患有 VLBW 的 LO-BSI 的婴儿经常发生多种感染（OR 9.2）。患有 LO-BSI 的婴儿分离出的微生物以革兰阳性球菌为主，主要为凝固酶阴性葡萄球菌（62.5%）。
VLBV 婴儿 LO-BSI 的独立危险因素是：低胎龄和手术需求。在波兰 NICUs 监测中，LO-BSI 的发生率，特别是 CVC-BSI 的发生率，高于其他国家网络，与中央和外周利用率相似。
