Nutritional Factors Associated with Late-Onset Sepsis in Very Low Birth Weight Newborns

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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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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Prolonged intravenous immunoglobulin treatment in very low birth weight infants with late onset sepsis

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-190259 ◽

2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

A. Bancalari Molina ◽

T. Muñoz Pérez ◽

P. Martínez Bengoechea

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Intravenous Immunoglobulin ◽

Very Low Birth Weight ◽

Late Onset ◽

Low Birth Weight Infants ◽

Late Onset Sepsis ◽

Immunoglobulin Treatment

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Procalcitonin as a Screening Test for Late-Onset Sepsis in Preterm Very Low Birth Weight Infants

Journal of Perinatology ◽

10.1038/sj.jp.7211296 ◽

2005 ◽

Vol 25 (6) ◽

pp. 397-402 ◽

Cited By ~ 43

Author(s):

Ramesh Vazzalwar ◽

Estela Pina-Rodrigues ◽

Bhagya L Puppala ◽

Denise B Angst ◽

Lorene Schweig

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Screening Test ◽

Very Low Birth Weight ◽

Late Onset ◽

Low Birth Weight Infants ◽

Late Onset Sepsis

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Extrauterine Growth Restriction in Low Birth Weight Infants

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.38.1.27 ◽

2019 ◽

Vol 38 (1) ◽

pp. 27-33 ◽

Cited By ~ 3

Author(s):

Kari Bonnar ◽

Debbie Fraser

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Neurodevelopmental Outcome ◽

Growth Failure ◽

Postnatal Growth ◽

Growth Restriction ◽

Low Birth Weight Infants ◽

Extrauterine Growth Restriction ◽

Postnatal Growth Failure

Extrauterine growth restriction (EUGR) affects a significant number of very low birth weight (VLBW) infants and has the potential to impact neurodevelopmental outcome as well as other aspects of long-term health. More aggressive nutritional approaches have reduced the incidence of postnatal growth failure but many questions remain about the expected rate of growth for very preterm infants, the best ways to measure growth velocity, and the optimal approaches to supporting growth. This article examines some of the outstanding issues regarding postnatal growth failure and summarizes current practice recommendations.

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Oropharyngeal Administration of Colostrum Increases Salivary Secretory IgA Levels in Very Low-Birth-Weight Infants

American Journal of Perinatology ◽

10.1055/s-0037-1603655 ◽

2017 ◽

Vol 34 (14) ◽

pp. 1389-1395 ◽

Cited By ~ 18

Author(s):

Coleen Greecher ◽

Kim Doheny ◽

Kristen Glass

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Late Onset ◽

Multicenter Trial ◽

Secretory Iga ◽

Control Group ◽

Low Birth Weight Infants ◽

Vlbw Infants ◽

Late Onset Sepsis

Aim Oropharyngeal administration of colostrum (OAC) has been proposed to provide mother's early milk to very low-birth-weight (VLBW) infants in the first few days of life. The aim of this study was to test the hypothesis that OAC would increase salivary secretory IgA (SsIgA). Patients and Methods Overall, 30 VLBW infants randomized to receive OAC or sterile water had salivary sampling for SsIgA on the day of life (DOL) 2, 7, and 14. The incidence of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) was determined prospectively. Within and between-group comparisons were made by paired and independent samples t-tests. Results Baseline characteristics were similar between groups. SsIgA was higher in OAC versus the control group (p < 0.05) on DOL 7, but not subsequently on DOL 14. There was no difference in LOS or NEC. Conclusion OAC increased SsIgA at DOL 7. A large, multicenter trial is needed to determine if OAC decreases LOS or NEC in VLBW infants.

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Clinicopathological Differences Between Early-onset and Late-onset Sepsis and Pneumonia in Very Low Birth Weight Infants

Pediatric Pathology ◽

10.3109/15513819009064710 ◽

1990 ◽

Vol 10 (5) ◽

pp. 757-768 ◽

Cited By ~ 8

Author(s):

Kyoko Itoh ◽

Hiroaki Aihara ◽

Satoshi Takada ◽

Masamitsu Nishino ◽

Yokei Lee ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Early Onset ◽

Very Low Birth Weight ◽

Late Onset ◽

Low Birth Weight Infants ◽

Late Onset Sepsis

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Human milk oligosaccharides and their association with late-onset neonatal sepsis in Peruvian very-low-birth-weight infants

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa102 ◽

2020 ◽

Vol 112 (1) ◽

pp. 106-112

Author(s):

Victor D Torres Roldan ◽

Meritxell Urtecho S ◽

Julia Gupta ◽

Chloe Yonemitsu ◽

Cesar P Cárcamo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Neonatal Sepsis ◽

Very Low Birth Weight ◽

Late Onset ◽

Human Milk Oligosaccharides ◽

Low Birth Weight Infants ◽

Milk Samples ◽

Late Onset Sepsis

ABSTRACT Background Oligosaccharides are the third most abundant component in human milk. They are a potential protective agent against neonatal sepsis. Objectives We aimed to explore the association between human milk oligosaccharides (HMOs) and late-onset sepsis in very-low-birth-weight infants, and to describe the composition and characteristics of HMOs in Peruvian mothers of these infants. Methods This is a secondary data analysis of a randomized clinical trial. We conducted a retrospective cohort study of mothers and their very-low-birth-weight (<1500 g) infants with ≥1 milk sample and follow-up data for >30 d. HMOs were measured by high performance liquid chromatography (HPLC). We used factor analysis and the Mantel–Cox test to explore the association between HMOs and late-onset neonatal sepsis. Results We included 153 mother–infant pairs and 208 milk samples. Overall, the frequency of the secretor phenotype was 93%. Secretors and nonsecretors were defined by the presence and near-absence of α1-2-fucosylated HMOs, respectively. The most abundant oligosaccharides were 2'-fucosyllactose, lacto-N-fucopentaose (LNFP) I, and difucosyllacto-N-tetraose in secretors and lacto-N-tetraose and LNFP II in nonsecretors. Secretors had higher amounts of total oligosaccharides than nonsecretors (11.45 g/L; IQR: 0.773 g/L compared with 8.04 g/L; IQR: 0.449 g/L). Mature milk samples were more diverse in terms of HMOs than colostrum (Simpson's Reciprocal Diversity Index). We found an association of factor 3 in colostrum with a reduced risk of late-onset sepsis (HR: 0.63; 95% CI: 0.41, 0.97). Fucosyl-disialyllacto-N-hexose (FDSLNH) was the only oligosaccharide correlated to factor 3. Conclusions These findings suggest that concentrations of different HMOs vary from one individual to another according to their lactation period and secretor status. We also found that FDSLNH might protect infants with very low birth weight from late-onset neonatal sepsis. Confirming this association could prove 1 more mechanism by which human milk protects infants against infections and open the door to clinical applications of HMOs. This trial was registered at clinicaltrials.gov as NCT01525316.

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