Trichosporon asahii late onset sepsis in an extremely low birth weight infant

BACKGROUND: Late-onset sepsis is common in extremely low birth weight (ELBW) infants, and it leads to the use of antibiotics to cover resistant organisms, which can be nephrotoxic. Here we have investigated the role of vancomycin plus piperacillin-tazobactam on the rate of acute kidney injury (AKI). METHODS: In a retrospective case-control study, medical records of all ELBW infants who were admitted to our Neonatal Intensive Care Unit (NICU) with late onset sepsis who were prescribed vancomycin plus piperacillin-tazobactam were reviewed for demographics, clinical characteristics, use of potential nephrotoxic medications and outcomes. RESULTS: During the study period, 264 patients were admitted, of whom 28.4%(75/264) received vancomycin plus piperacillin-tazobactam and were matched with 64 controls. There were no differences in gestational age or birth weight between cases and controls [688±160 vs. 689±162 grams (p = 0.99), and 24.7±1.8 vs. 24.7±1.6 weeks (p = 0.99) respectively]. There was no difference in the rate of sepsis between cases and controls [76%(55/72) vs. 64%(41/64) respectively, p = 0.11]. Infants exposed to vancomycin plus piperacillin-tazobactam had a higher percentage of concomitant use of vasopressors and amphotericin. To adjust for confounders, a logistic regression analysis was conducted with AKI as the dependent variable. Use of vasopressors and vancomycin plus piperacillin-tazobactam were the only risk factors associated with AKI with an adjusted OR (95%CI) of 4.08 (1.90–8.74), p < 0.001; and 2.87 (1.26–6.53), p = 0.01 respectively. CONCLUSION: The use of vancomycin plus piperacillin-tazobactam in ELBW infants is associated with an increased risk for AKI.

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Late-Onset Circulatory Dysfunction After Thyroid Hormone Treatment in an Extremely Low Birth Weight Infant

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem.2010.23.1-2.153 ◽

2010 ◽

Vol 23 (1-2) ◽

Cited By ~ 16

Author(s):

H. Yagasaki ◽

K. Kobayashi ◽

A. Nemoto ◽

A. Naito ◽

K. Sugita ◽

...

Keyword(s):

Birth Weight ◽

Thyroid Hormone ◽

Low Birth Weight ◽

Late Onset ◽

Hormone Treatment ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infant

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Successful Treatment of Late-Onset Infection due to Resistant Klebsiella pneumoniae in an Extremely Low Birth Weight Infant Using Ciprofloxacin

Journal of Perinatology ◽

10.1038/sj.jp.7200084 ◽

1999 ◽

Vol 19 (4) ◽

pp. 311-314 ◽

Cited By ~ 16

Author(s):

Munish Khaneja ◽

James Naprawa ◽

Alok Kumar ◽

Steve Piecuch

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Klebsiella Pneumoniae ◽

Successful Treatment ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infant ◽

Late Onset Infection

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Vancomycin Prophylaxis for Late-Onset Sepsis in Very Low and Extremely Low Birth Weight Neonates

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.27.5.351 ◽

2008 ◽

Vol 27 (5) ◽

pp. 351-354 ◽

Cited By ~ 1

Author(s):

Susan Givens Bell

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Late Onset ◽

Bloodstream Infections ◽

Extremely Low Birth Weight ◽

Causative Organism ◽

Published Data ◽

Late Onset Sepsis ◽

Elbw Neonates ◽

Central Catheters

LATE-ONSET SEPSIS AMONG very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates is a troubling occurrence. The most recently published data from the National Nosocomial Infection Surveillance system documents 5.4 umbilical- and central line–related bloodstream infections (BSIs) per 1,000 catheter days in infants weighing between 1,001 and 1,500 g.1 For infants weighing 1,000 g or less, the rate is 9.1 infections per 1,000 catheter days. A variety of factors, including prematurity and related relative immunocompromise, altered skin integrity, and multiple invasive procedures, places VLBW and ELBW neonates at risk for infection. Tunneled central catheters or peripherally inserted central catheters (PICCs) clearly add to the risk of infection in these vulnerable patients. In a point prevalence survey of a network of 29 NICUs, researchers found that coagulase-negative Staphylococcus (CoNS) was the causative organism in nearly half (48.3 percent) of the documented bloodstream infections.2 Vancomycin prophylaxis is a potential strategy for the prevention of late-onset sepsis associated with CoNS. This column explores the efficacy and safety of this strategy.

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Late-Onset Sepsis as a Risk Factor for Bronchopulmonary Dysplasia in Extremely Low Birth Weight Infants: A Nationwide Cohort Study

Scientific Reports ◽

10.1038/s41598-019-51617-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 5

Author(s):

Euiseok Jung ◽

Byong Sop Lee

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Bronchopulmonary Dysplasia ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Late Onset Sepsis ◽

The Impact ◽

Multiple Episodes

Abstract This study aimed to determine the effect of late-onset sepsis (LOS) on the development of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants. A prospective cohort study was performed using data collected from 64 centres registered in the Korean national registry. LOS was defined as a positive blood culture and antibiotics treatment after 72 hours of life and prior to 36 weeks postmenstrual age (PMA). Data on the causative organisms were collected and analysed for respiratory outcomes. Among the 1,434 ELBW infants who survived to 36 weeks PMA, 481 (34%) developed LOS caused by bacteria (n = 405), fungi (n = 28), or both (n = 48). The incidence of BPD was significantly associated with LOS in both the entire cohort and the propensity score-matched cohort. Two or more LOS episodes were a risk factor for BPD. The impact of multiple episodes of LOS on BPD was prominent in infants who received mechanical ventilation for two weeks or less. The estimated odds ratios for BPD and severe BPD were greater with fungal LOS than with bacterial LOS. In conclusion, LOS, particularly complicated by multiple episodes and/or fungi, was a risk factor for BPD in ELBW infants.

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Unexplained Late-Onset Hemolytic Jaundice Preceded by High Fetal Hemoglobin Level in an Extremely Low Birth Weight Infant

Clinical Laboratory ◽

10.7754/clin.lab.2019.190625 ◽

2020 ◽

Vol 66 (01+02/2020) ◽

Author(s):

GoEun Kwon ◽

Aya Okahashi ◽

Nobuhiko Nagano ◽

Chihiro Nozaki ◽

Erina Nakahara ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Late Onset ◽

Fetal Hemoglobin ◽

Hemoglobin Level ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infant ◽

Fetal Hemoglobin Level

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Parenteral Glutamine Supplementation Does Not Reduce the Risk of Mortality or Late-Onset Sepsis in Extremely Low Birth Weight Infants

PEDIATRICS ◽

10.1542/peds.113.5.1209 ◽

2004 ◽

Vol 113 (5) ◽

pp. 1209-1215 ◽

Cited By ~ 116

Author(s):

B. B. Poindexter ◽

R. A. Ehrenkranz ◽

B. J. Stoll ◽

L. L. Wright ◽

W. K. Poole ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Glutamine Supplementation ◽

Low Birth Weight Infants ◽

Risk Of Mortality ◽

Late Onset Sepsis

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Clinical And Laboratory Findings Of Late Onset Sepsis In Extremely Low Birth Weight Infants According To Causative Organisms

10.21203/rs.3.rs-444934/v1 ◽

2021 ◽

Author(s):

Kyung Hee Park ◽

Mi Hye Bae ◽

Na Rae Lee ◽

Young Mi Han ◽

Shin-Yun Byun

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Age Of Onset ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Negative Group ◽

Gram Positive ◽

Laboratory Findings ◽

Gram Negative ◽

Late Onset Sepsis

Abstract Background: Late onset sepsis (LOS) remains a significant source of morbidity and mortality in extremely low birth weight (ELBW) infants. Early and accurate diagnosis is very important but is difficult due to the similarities in clinical manifestation between the causative microorganisms. We tried to identify the differences between causative microorganisms in clinical and laboratory findings, when sepsis was suspected in ELBW infants.Methods: A retrospective study was conducted on preterm infants born at less than 28 weeks of gestation with a birth weight of less than 1,000 g between January 2009 and December 2019. Clinical and laboratory findings of suspected LOS were assessed. We classified them into three groups according to blood culture results (gram-positive, gram-negative, and fungal groups) and compared them. Results: A total of 107 patients were included after using the exclusion criteria, with 45 (31.5%) in the gram-positive group, 35 (17.5%) in the gram-negative group, and 27 (11.5%) in the fungal group. There were no significant differences in mean gestational age, birth weight, and neonatal morbidities, except for the age of onset, which was earlier in the fungal group than in the bacterial groups. White blood cell (WBC) counts were the highest in the gram-negative group and the lowest in the fungal group. The mean platelet counts were significantly lower in the fungal group (137,000/mm3, 100,000/mm3, and 61,000/mm3 in the gram-positive, gram-negative, and fungal groups, respectively; p< 0.001). C-reactive protein (CRP) levels were significantly higher in the gram-negative group, while glucose was significantly higher in the fungal group. Conclusion: In conclusion, we showed that there are some differences in laboratory findings, according to causative microorganisms, in the LOS of ELBW infants. WBC and CRP were increased in gram-negative infection, and thrombocytopenia and hyperglycemia were predominant in fungal infection. These data may be helpful for choosing empirical antibiotics when sepsis is suspected.

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