Pichler Karin, Giordano Vito, Tropf Gereon, Fuiko Renate, Berger Angelika, Rittenschober-Boehm Judith
Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria.
Children (Basel). 2021 Mar 9;8(3):207. doi: 10.3390/children8030207.
Nosocomial infections (NIs) are important conditions associated with mortality and morbidity in very low birth weight infants (VLBWIs). The aim of this study was to investigate the impact of NIs and the different subtypes on neurodevelopmental outcomes in a cohort of VLBWIs. VLBWIs born with a gestational age between 23 and 31 weeks in a level III neonatal center were enrolled. Neonatal morbidities as well as the neurodevelopmental outcome at 2 years of corrected age were analyzed. Six-hundred infants completed the study successfully. Of these, 38% experienced an NI episode. NIs were associated with an increased risk of neonatal complications, such as brain injury, bronchopulmonary dysplasia (BPD) and death, and were a significant risk factor for adverse motor development at 2 years of corrected age in our cohort of VLBWIs. The negative impact of NIs on neurodevelopmental outcomes was particularly associated with necrotizing enterocolitis (NEC), suspected NIs and Gram-positive NIs. This study demonstrated that NIs are a significant risk factor for both morbidity and mortality as well as adverse neurodevelopmental outcomes in VLBWIs.
医院感染（NIs）是与极低出生体重儿（VLBWIs）的死亡率和发病率相关的重要情况。本研究的目的是调查医院感染及其不同亚型对一组极低出生体重儿神经发育结局的影响。纳入了在三级新生儿中心出生、胎龄在23至31周之间的极低出生体重儿。分析了新生儿发病率以及矫正年龄2岁时的神经发育结局。600名婴儿成功完成了研究。其中，38%经历了医院感染事件。医院感染与新生儿并发症（如脑损伤、支气管肺发育不良（BPD）和死亡）风险增加相关，并且在我们的极低出生体重儿队列中，是矫正年龄2岁时运动发育不良的重要危险因素。医院感染对神经发育结局的负面影响尤其与坏死性小肠结肠炎（NEC）、疑似医院感染和革兰氏阳性菌医院感染相关。本研究表明，医院感染是极低出生体重儿发病、死亡以及不良神经发育结局的重要危险因素。
