Bedetti Luca, Corso Lucia, Miselli Francesca, Guidotti Isotta, Toffoli Carlotta, Miglio Rossella, Roversi Maria Federica, Muttini Elisa Della Casa, Pugliese Marisa, Bertoncelli Natascia, Zini Tommaso, Mazzotti Sofia, Lugli Licia, Lucaccioni Laura, Berardi Alberto
Neonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, Italy.
Pediatric Postgraduate School, University of Modena and Reggio Emilia, 41121 Modena, Italy.
J Clin Med. 2024 Feb 17;13(4):1140. doi: 10.3390/jcm13041140.
(1) Background: Prematurity is a serious condition associated with long-term neurological disability. This study aimed to compare the neurodevelopmental outcomes of preterm neonates with or without sepsis. (2) Methods: This single-center retrospective case-control study included infants with birth weight < 1500 g and/or gestational age ≤ 30 weeks. Short-term outcomes, brain MRI findings, and severe functional disability (SFD) at age 24 months were compared between infants with culture-proven or culture-negative sepsis or without sepsis. A chi-squared test or Mann-Whitney U test was used to compare the clinical and instrumental characteristics and the outcomes between cases and controls. (3) Results: Infants with sepsis (all sepsis n = 76; of which culture-proven n = 33 and culture-negative n = 43) were matched with infants without sepsis (n = 76). Compared with infants without sepsis, both all sepsis and culture-proven sepsis were associated with SFD. In multivariate logistic regression analysis, SFD was associated with intraventricular hemorrhage (OR 4.7, CI 1.7-13.1, = 0.002) and all sepsis (OR 3.68, CI 1.2-11.2, = 0.021). (4) Conclusions: All sepsis and culture-proven sepsis were associated with SFD. Compared with infants without sepsis, culture-negative sepsis was not associated with an increased risk of SFD. Given the association between poor outcomes and culture-proven sepsis, its prevention in the neonatal intensive care unit is a priority.
(1) 背景：早产是一种与长期神经功能残疾相关的严重病症。本研究旨在比较患有或未患有败血症的早产新生儿的神经发育结局。(2) 方法：这项单中心回顾性病例对照研究纳入了出生体重<1500 g和/或胎龄≤30周的婴儿。比较了经培养证实或培养阴性败血症或无败血症婴儿的短期结局、脑部MRI检查结果以及24个月时的严重功能残疾情况。采用卡方检验或曼-惠特尼U检验比较病例组和对照组之间的临床和器械特征及结局。(3) 结果：患有败血症的婴儿（所有败血症n = 76；其中经培养证实的n = 33，培养阴性的n = 43）与未患有败血症的婴儿（n = 76）进行匹配。与未患有败血症的婴儿相比，所有败血症和经培养证实的败血症均与严重功能残疾相关。在多因素逻辑回归分析中，严重功能残疾与脑室内出血（OR 4.7，CI 1.7 - 13.1，P = 0.002）和所有败血症（OR 3.68，CI 1.2 - 11.2，P = 0.021）相关。(4) 结论：所有败血症和经培养证实的败血症均与严重功能残疾相关。与未患有败血症的婴儿相比，培养阴性败血症与严重功能残疾风险增加无关。鉴于不良结局与经培养证实的败血症之间的关联，在新生儿重症监护病房预防该病是当务之急。
