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Bloodstream infections in very low birth weight infants with intestinal failure

Conrad R Cole1, Nellie I Hansen, Rosemary D Higgins

  • 1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. conrad.cole@cchmc.org

The Journal of Pediatrics
|August 16, 2011
PubMed

Insights

Recurrent bloodstream infections (BSIs) are common in infants with intestinal failure (IF) following necrotizing enterocolitis (NEC). Gram-positive bacteria were the most frequent pathogens identified in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Infectious Diseases
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
  • Intestinal failure (IF) often results from NEC, requiring extensive medical support.
  • Late-onset bloodstream infections (BSIs) pose a significant threat to infants with IF.

Purpose of the Study:

  • To investigate the pathogens and characteristics of late-onset BSIs in infants with IF secondary to NEC.
  • To compare BSI frequency and pathogens across different NEC management groups.
  • To evaluate outcomes in infants with IF, including parenteral nutrition duration and feeding achievement.

Main Methods:

  • A cohort study of 932 infants weighing 401-1500g at birth across Neonatal Research Network centers.
  • Comparison of culture-positive BSI rates and pathogens in medically managed NEC, surgically managed NEC without IF, and surgical IF groups.
  • Analysis of parenteral nutrition duration and feeding outcomes in infants with IF.

Main Results:

  • Infants with IF had a higher proportion of BSIs post-NEC diagnosis compared to surgical NEC without IF (P = .007) and medical NEC (P < .001).
  • Gram-positive pathogens were the most common organisms identified.
  • In IF infants, increased infections correlated with longer hospitalization (P = .06), longer PN duration (P = .003), and lower rates of achieving full feeds (P = .03).

Conclusions:

  • Recurrent BSIs are a frequent complication in very low birth weight infants with IF.
  • Gram-positive bacteria are the predominant pathogens in BSIs among infants with IF.
  • Effective management of BSIs is crucial for improving outcomes in infants with IF.
Abstract

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