UNASSIGNED: This ancillary study of the SEPREVEN trial included neonates hospitalized ≥2 days in one of 12 French NICUs and with ≥ 1 BSI during the 20-month study period. BSIs (all primary and health care-associated) were diagnosed in infants with symptoms suggestive of infection and classified prospectively as possible (one coagulase-negative staphylococci (CoNS)-growing blood culture) or proven (two same CoNS, or ≥1 recognized pathogen-growing blood culture). BSI consequences were collected prospectively as moderate morbidity (antibiotic treatment alone) or severe morbidity/mortality (life-saving procedure, permanent damage, prolonged hospitalization, and/or death).
UNASSIGNED: Of 557 BSIs identified in 494 patients, CoNS accounted for 378/557 (67.8%) and recognized bacterial or fungal pathogens for 179/557 (32.1%). Severe morbidity/mortality was reported in 148/557 (26.6%) BSIs. Independent factors associated with severe morbidity/mortality were corrected gestational age <28 weeks (CGA) at infection (P < .01), fetal growth restriction (FGR) (P = .04), and proven pathogen-related BSI vs. CoNS-related BSI (P < .01). There were no differences in severe morbidity and mortality between proven and possible CoNS BSIs. In possible BSI, S. epidermidis was associated with a lower risk of severe morbidity than other CoNS (P < .01), notably S. capitis and S. haemolyticus.
UNASSIGNED: In BSIs in the NICU, severe morbidity/mortality was associated with low CGA at infection, FGR, and proven pathogen-related BSIs. When only one blood culture was positive, severe morbidity/mortality were less frequent if it grew with S. epidermidis compared to other CoNS. Further studies to help distinguish real CoNS BSIs from contaminations are needed.
UNASSIGNED: ClinicalTrials.gov (NCT02598609).
■这项SEPREVEN试验的辅助研究包括在20个月的研究期间,在12个法国NICU中住院≥2天并且BSI≥1的新生儿。BSI(所有初级和医疗保健相关)在有感染症状的婴儿中被诊断出来,并尽可能进行前瞻性分类(一种凝固酶阴性葡萄球菌(CoNS)-生长的血培养)或证实(两种相同的CoNS,或≥1个公认的病原体生长血培养物)。BSI后果被前瞻性地收集为中度发病率(单独的抗生素治疗)或重度发病率/死亡率(救生程序,永久性损伤,住院时间延长,和/或死亡)。
■在494名患者中确定的557个BSI中,CoNS占378/557(67.8%),公认的细菌或真菌病原体占179/557(32.1%)。148/557(26.6%)BSI报告了严重的发病率/死亡率。与严重发病率/死亡率相关的独立因素是感染时校正胎龄<28周(CGA)(P<0.01),胎儿生长受限(FGR)(P=.04),和证明与病原体相关的BSIvs.CoNS相关的BSI(P<0.01)。已证实和可能的CoNSBSIs之间的严重发病率和死亡率没有差异。在可能的BSI中,与其他CoNS相比,表皮葡萄球菌的严重发病率风险较低(P<0.01),特别是S.capitis和溶血链球菌。
■在NICU的BSI中,严重的发病率/死亡率与感染时的低CGA相关,FGR,和已证明与病原体相关的BSI。当只有一个血培养阳性时,与其他CoNS相比,与表皮葡萄球菌一起增长的严重发病率/死亡率较低.需要进一步的研究来帮助区分真实的CoNSBSI与污染物。
■ClinicalTrials.gov(NCT02598609)。