ArticlePediatric research2023
Organ dysfunction and mortality in preterm neonates with late-onset bloodstream infection.
Article in Pediatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 5 citations in OpenAlex.
- Heterogeneity of Critical Organ Dysfunction During Late-Onset Bacteremia in Preterm Infants.JAMA network open · 2026Observational
- Clinical features, risk factors and 28-day mortality in neonates with carbapenem-resistant sepsis or meningitis in a South African tertiary neonatal unit: a prospective cohort study.BMJ public health · 2026Article
- Outcome prediction for late-onset sepsis after premature birth.Pediatric research · 2025Article
- Advancing early risk prediction for preterm neonates with late-onset sepsis: a step toward precision medicine.Pediatric research · 2025Article
- Hemadsorption with CytoSorb in Infants with Sepsis: Non-Systematic Review of Cases.Journal of clinical medicine · 2024Review
- Baricitinib protects mice from sepsis-induced cardiac dysfunction and multiple-organ failure.Frontiers in immunology · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOrgan dysfunction (ODF) in late-onset bloodstream infection (LBSI) is associated with increased risk of adverse outcomes. However, no established definition of ODF exists among preterm neonates. Our objective was to describe an outcome-based ODF definition for preterm infants, and assess factors associated with mortality.
methodsThis is a six-year retrospective study of neonates <35 weeks gestational age, >72 h of age, with non-CONS bacterial/fungal LBSI. Discriminatory ability of each parameter for mortality was evaluated: base deficit ≤-8 mmol/L (BD8), renal dysfunction (urine output <1 cc/kg/h or creatinine ≥100 μmol/L), hypoxic respiratory failure (HRF, ventilated, FiO
resultsOne hundred and forty-eight infants had LBSI. BD8 had the highest individual predictive ability for mortality (AUROC = 0.78). The combination BD8 + HRF + V/I was used to define ODF (AUROC = 0.84). Fifty-seven (39%) infants developed ODF, among which 28 (49%) died. Mortality increased inversely relative to GA at LBSI-onset (aOR 0.81 [0.67, 0.98]) and directly relative to ODF occurrence (12.15 [4.48, 33.92]). Compared to no-ODF, ODF infants had lower GA and age at illness, and higher frequency of Gram-negative pathogen.
conclusionsAmong preterm neonates with LBSI, significant metabolic acidosis, HRF, and vasopressor/inotrope use may identify infants high risk for mortality. These criteria could help identify patients for future studies of adjunctive therapies. IMPACT: Sepsis-related organ dysfunction is associated with increased risk of adverse outcomes. Among preterm neonates, significant metabolic acidosis, use of vasopressors/inotropes, and hypoxic respiratory failure may identify high-risk infants. This can be used to target research and quality improvement efforts toward the most vulnerable infants.
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