ArticleNeonatology2019
Risk Factors for Late-Onset Sepsis in Preterm Infants: A Multicenter Case-Control Study.
Article in Neonatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants.The Cochrane database of systematic reviews · 2022Pooled it
- Intervention Effect of Oropharyngeal Administration of Colostrum in Preterm Infants: A Meta-Analysis.Frontiers in pediatrics · 2022Pooled it
- Effects of oropharyngeal administration of colostrum on the incidence of necrotizing enterocolitis, late-onset sepsis, and death in preterm infants: a meta-analysis of RCTs.European journal of clinical nutrition · 2020Pooled it
- Trial
- Mechanisms affecting the gut of preterm infants in enteral feeding trials: a nested cohort within a randomised controlled trial of lactoferrin.Archives of disease in childhood. Fetal and neonatal edition · 2023Trial
- Immune Impairment in Preterm Neonates and Its Impact on Morbidity.Indian journal of pediatrics · 2026Review
- The gut-lung axis in early life: microbiome-associated mechanisms and clinical relevance.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Neonatal enteral antibiotics reduce gut inflammation and delay systemic immune development in preterm pigs.Pediatric research · 2026Article
- A Review of Probiotic Interventions for Necrotizing Enterocolitis and Sepsis in Preterm Infants.International journal of molecular sciences · 2026Review
- Sepsis profile among preterm infants with enterostomy and fecal transfer: a multicenter retrospective cohort study.Molecular and cellular pediatrics · 2026Article
- Bacterial and fungal infections in infants born before 24 weeks' gestation: a review.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Prevalence of multidrug-resistant organisms colonizing neonates at a tertiary hospital in Johannesburg, South Africa.Journal of tropical pediatrics · 2026Article
- Hospital-acquired infections in preterm infants with gestational age <32 weeks: a retrospective study of clinical characteristics, pathogen distribution, and associated factors.Frontiers in pediatrics · 2026Article
- Role of maternal milk in providing a healthy intestinal microbiome for the preterm neonate.Pediatric research · 2025Review
- Epidemiology and Outcomes of Late-Onset Neonatal Sepsis in Preterm Infants in a Tertiary Hospital.Children (Basel, Switzerland) · 2025Article
- The association of early antibiotic exposure with subsequent development of late-onset sepsis in preterm infants: a systematic review and meta-analysis studies.International journal of emergency medicine · 2025Review
- Effects of Caffeine on THP-1 Myelogenous Cell Inflammatory Gene Expression.Current issues in molecular biology · 2025Article
- Retrospective Evaluation of Empiric Vancomycin Therapy for Infectious Workups in Relation to Methicillin-ResistantThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Elimination ofAntibiotics (Basel, Switzerland) · 2025Article
- Role of DNA methylation in regulating inflammatory cytokine expression in neonates with late-onset sepsis.Frontiers in immunology · 2025Article
Corrections and comments
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Authors and funding
16 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLate-onset sepsis (LOS) in preterm infants is a leading cause of mortality and morbidity. Timely recognition and initiation of antibiotics are important factors for improved outcomes. Identification of risk factors could allow selection of infants at an increased risk for LOS.
objectivesThe aim was to identify risk factors for LOS.
methodsIn this multicenter case-control study, preterm infants born at ≤30 weeks of gestation were included at 9 neonatal intensive care units. Detailed demographical and clinical data were collected daily up to day 28 postnatally. Clinical and demographic risk factors were identified using univariate and multivariate regression analyses in a 1: 1 matched case-control cohort.
resultsIn total, 755 infants were included, including 194 LOS cases (41 gram-negative cases, 152 gram-positive cases, and 1 fungus). In the case-control cohort, every additional day of parenteral feeding increased the risk for LOS (adjusted OR = 1.29; 95% CI 1.07-1.55; p = 0.006), whereas antibiotics administration decreased this risk (OR = 0.08; 95% CI 0.01-0.88; p = 0.039). These findings could largely be attributed to specific LOS-causative pathogens, since these predictive factors could be identified for gram-positive, but not for gram-negative, LOS cases. Specifically cephalosporins administration prior to clinical onset was inversely related to coagulase-negative staphylococcus LOS (CoNS-LOS) development. Formula feeding was an independent risk factor for development of CoNS-LOS (OR = 3.779; 95% CI 1.257-11.363; p = 0.018).
conclusionThe length of parenteral feeding was associated with LOS, whereas breastmilk administration was protective against CoNS-LOS. A rapid advancement of enteral feeding, preferably with breastmilk, may proportionally reduce the number of parenteral feeding days and consequently the risk for LOS.
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