1019 Standardized Versus Individualized Parenteral Nutrition in Very-Low-Birth-Weight Infants: A Comparative Study

Background: Delayed onset of minimal enteral nutrition compromises the immune response of preterm infants, increasing the risk of colonization and clinical complications (e.g., late-onset sepsis). This study aimed to analyze associations between late-onset sepsis in very low birth weight infants (<1500 g) and days of parenteral nutrition, days to reach full enteral nutrition, and maternal and nutritional factors. Methods: A cross-sectional study was carried out with very low birth weight infants admitted to a neonatal intensive care unit (NICU) of a reference maternity hospital of high-risk deliveries. Data regarding days of parenteral nutrition, days to reach full enteral nutrition, fasting days, extrauterine growth restriction, and NICU length of stay were extracted from online medical records. Late-onset sepsis was diagnosed (clinical or laboratory) after 48 h of life. Chi-squared, Mann–Whitney tests, and binary logistic regression were applied. Results: A total of 97 preterm infants were included. Of those, 75 presented late-onset sepsis with clinical (n = 40) or laboratory (n = 35) diagnosis. Maternal urinary tract infection, prolonged parenteral nutrition (>14 days), and extrauterine growth restriction presented 4.24-fold, 4.86-fold, and 4.90-fold higher chance of late-onset sepsis, respectively. Conclusion: Very low birth weight infants with late-onset sepsis had prolonged parenteral nutrition and took longer to reach full enteral nutrition. They also presented a higher prevalence of extrauterine growth restriction than infants without late-onset sepsis.

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Effect of Total Parenteral Nutrition on Lipase Activity in the Stomach of Very Low Birth Weight Infants

Neonatology ◽

10.1159/000242800 ◽

1988 ◽

Vol 53 (5) ◽

pp. 261-266 ◽

Cited By ~ 2

Author(s):

Nitin R. Mehta ◽

Teresa H. Liao ◽

Margit Hamosh ◽

Yolande F. Smith ◽

Paul Hamosh

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Lipase Activity ◽

Very Low Birth Weight ◽

Low Birth Weight Infants

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Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822011005000045 ◽

2011 ◽

Vol 44 (4) ◽

pp. 447-450 ◽

Cited By ~ 4

Author(s):

Priscila Castro Cordeiro Fernandes ◽

Elias Jose Oliveira von Dolinger ◽

Vânia Olivetti Steffen Abdallah ◽

Daiane Silva Resende ◽

Paulo Pinto Gontijo Filho ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Central Venous Catheter ◽

Parenteral Nutrition ◽

Very Low Birth Weight ◽

Late Onset ◽

Venous Catheter ◽

Central Venous ◽

Low Birth Weight Infants ◽

Late Onset Sepsis

INTRODUCTION: The purpose of this study was to establish the late onset sepsis (LOS) rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN). METHODS: Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC) tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip. RESULTS: 74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4%) infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2%) and blood (67.8%). All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation. CONCLUSIONS: In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.

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