Evidence map›Paper›PMID 38146858›Full record

ArticleJournal of the Pediatric Infectious Diseases Society2023

Late-Onset Sepsis Evaluation and Empiric Therapy in Extremely Low Gestational Age Newborns.

Rebecca L Speier, C Michael Cotten, Daniel K Benjamin, Kelsey Lewis, Kristin Keeler, Glory Kidimbu, William Roberts, Reese H Clark, Kanecia O Zimmerman, Ashley Stark and 1 more

Open access · bronzeAbstract read
In one paragraph

Article in Journal of the Pediatric Infectious Diseases Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Rebecca L SpeierDepartment of Medicine, Duke University School of Medicine.
C Michael CottenDepartment of Medicine, Duke University School of Medicine.
Daniel K BenjaminDepartment of Medicine, Duke University School of Medicine.
Kelsey LewisDuke Clinical Research Institute, Durham, NC, USA.
Kristin KeelerDuke Clinical Research Institute, Durham, NC, USA.
Glory KidimbuDuke Clinical Research Institute, Durham, NC, USA.
William RobertsDuke Clinical Research Institute, Durham, NC, USA.
Reese H ClarkPediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA.ORCID 0000-0002-7363-4640
Kanecia O ZimmermanDepartment of Medicine, Duke University School of Medicine.
Ashley StarkDepartment of Medicine, Duke University School of Medicine.
Rachel G GreenbergDepartment of Medicine, Duke University School of Medicine.
Duke University · USClinical Research Institute · USMednax (United States) · US

Funding

COVID-19 Supplement - Center for Innovative TRIals in ChilDrEN and AdulTs (TRIDENT)U24TR001608 · NCATS · DUKE UNIVERSITY · PI BENJAMIN, DANIEL K., BERNARD, GORDON RAPHAEL · 2016 to 2022
$177.0M
NIH Summer Research Experience Programs (R25)R25HD076475 · NICHD · DUKE UNIVERSITY · PI BENJAMIN, DANIEL K. · 2013 to 2023
$1.1M
NCATS NIH HHS U24 TR001608NICHD NIH HHS HHSN275201000003CNICHD NIH HHS HHSN275201000003INICHD NIH HHS R25 HD076475
6 · The paper itself

Abstract

backgroundLittle is known about late-onset sepsis (LOS) evaluations in extremely low gestational age newborns (ELGANs). We describe frequencies of LOS evaluation in ELGANs, infant characteristics, and empiric therapy choices during evaluations.

methodsCohort study of infants 22-28 weeks gestational age (GA) discharged from 243 centers from 2009 to 2018, excluding infants with congenital anomalies, discharged or deceased prior to postnatal day (PND) 2, or admitted after PND 2. A new LOS evaluation was defined as the first blood culture obtained between PND 3 and 90, or one obtained ≥1 day following a negative culture and ≥10 days from prior positive cultures. We determined numbers of evaluations and percentage positive by GA, center, and over time. We described characteristics associated with positive evaluations, infants with LOS, and empiric antimicrobials. We calculated descriptive and comparative statistics using Wilcoxon rank sum, Fisher's exact, or Pearson chi-square tests, as appropriate.

resultsOf 47,187 included infants, 67% had ≥1 LOS evaluation and 21% of evaluated infants had ≥1 LOS (culture positive) episode; 1.6 evaluations occurred per infant and 10% were positive. The percentage of infants evaluated and positive for LOS was higher at earlier GA. LOS was associated with inotrope support (15% vs. 9%; p < .001) and invasive mechanical ventilation (66% vs. 51%; p < .001). Infants with positive cultures were more likely than infants with negative cultures to receive empiric antimicrobials during the LOS evaluation (95% vs. 73%; p < .001).

conclusionsAmong ELGANs, earlier GA and postnatal age were associated with LOS evaluation and positive cultures. Most infants undergoing evaluation were started on empiric antimicrobials.

Indexed as

SepsisCohort StudiesGestational AgeHumansInfantInfant, NewbornRisk Factorsantimicrobialsempiric therapyextremely low gestational age newbornslate-onset sepsis

Identifiers

PMID38146858
PMCPMC12301717
OpenAlexW4390229613

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.