Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Eur J Pediatr. 2019 May;178(5):673-680. doi: 10.1007/s00431-019-03339-2. Epub 2019 Feb 18.
Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. This prospective cohort study aims to establish the effect of sepsis after 72 h of life on cognitive, psychomotor, and language development of preterm infants (below 32 weeks gestational age and/or below 1500 g). At 2 years corrected age, neurodevelopmental outcome was tested using Bayley's Scales of Infant Development-II, Lexilijst (lexical development questionnaire), and behavior checklists. Of 117 patients included, 85 experienced blood culture-proven infection. Coagulase-negative staphylococci were responsible for 55% of the episodes. No significant differences were found in cognitive, motor, and behavioral scores or lexiquotient comparing patients with versus no proven infection. When comparing three groups (coagulase-negative staphylococci, other, and negative blood culture), a significant difference was found in composite cognitive scores (p = 0.016), in favor of the coagulase-negative staphylococci group versus other causal agent group (p = 0.007). No significant differences were found in other subscales.Conclusion: In this cohort, no differences were found in neurodevelopmental outcome at 2 years corrected age between proven and no proven infection groups; confirmation in larger cohorts with a control group is needed. Patients encountering coagulase-negative staphylococci sepsis showed a significant better cognitive outcome compared to other causal agents. What is Known: • Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. What is New: • Preterm infants encountering late-onset sepsis by coagulase-negative staphylococci show a better cognitive outcome in comparison to other causal infectious agents in this cohort. • No differences were found in neurodevelopment at 2 years of age in preterm infants with suspected lateonset sepsis, between proven and no proven infection groups. Confirmation is needed in larger cohorts with a substantial control group.
晚发型败血症与早产儿神经发育不良结局有关。本前瞻性队列研究旨在确定生后 72 小时后败血症对早产儿（胎龄<32 周和/或体重<1500g）认知、精神运动和语言发育的影响。在 2 岁时，使用贝利婴幼儿发展量表 II、Lexilijst（词汇发展问卷）和行为检查表测试神经发育结局。在 117 名纳入的患者中，85 名患者有血培养阳性感染。凝固酶阴性葡萄球菌引起的感染占 55%。比较有或无血培养阳性感染的患者，在认知、运动和行为评分或词汇量方面无显著差异。比较凝固酶阴性葡萄球菌、其他和血培养阴性三组时，复合认知评分存在显著差异（p=0.016），凝固酶阴性葡萄球菌组优于其他病因组（p=0.007）。其他子量表无显著差异。结论：在本队列中，在 2 岁时，有或无血培养阳性感染的患者之间的神经发育结局无显著差异；需要在更大的队列中进行，且需要设立对照组。与其他病原体相比，凝固酶阴性葡萄球菌败血症患者的认知结局显著更好。已知：• 晚发型败血症与早产儿神经发育不良结局有关。新发现：• 在本队列中，与其他病原体相比，凝固酶阴性葡萄球菌引起的晚发型败血症早产儿的认知结局更好。• 在疑似晚发型败血症的早产儿中，有或无血培养阳性感染的患者之间在 2 岁时的神经发育无差异。需要在更大的队列中进行，且需要设立对照组。
