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Updated: Mar 18, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
[Risk Factors for Healthcare Associated Sepsis in Very Low Birth Weight Infants]
Helena Pereira1, Ema Grilo2, Patrícia Cardoso2
1Serviço de Pediatria. Centro Hospitalar de Trás-os-Montes e Alto Douro. Unidade de Vila Real. Vila Real. Serviço de Pediatria. Maternidade Bissaya Barreto. Centro Hospitalar e Universitário de Coimbra. Coimbra.
Insights
Healthcare-associated sepsis (HS) in very low birth weight infants is linked to gestational age and parenteral nutrition duration. Lower gestational age and longer parenteral nutrition increase sepsis risk in these vulnerable infants.
Area of Science:
- Neonatology
- Infectious Diseases
- Pediatrics
Background:
- Healthcare-associated infections (HAIs) pose significant risks, including mortality and increased costs, for very low birth weight infants.
- Evaluating the incidence and risk factors for healthcare-associated sepsis (HS) is crucial for improving outcomes in this population.
Purpose of the Study:
- To determine the rate of healthcare-associated sepsis (HS) in very low birth weight infants.
- To identify significant risk factors associated with HS in this vulnerable group.
Main Methods:
- A retrospective observational study was conducted over ten years (2005-2014) in a Neonatal Intensive Care Unit.
- Data from 461 very low birth weight infants were analyzed to identify associations between risk factors and HS.
Main Results:
- 110 episodes of HS occurred, with a sepsis density of 7.5 per 1,000 hospitalization days.
- Infants with HS had significantly lower birth weight and gestational age.
- Independent risk factors identified were lower gestational age and longer duration of parenteral nutrition.
Conclusions:
- Gestational age and duration of parenteral nutrition are independent predictors of healthcare-associated sepsis in very low birth weight infants.
- Each additional week of gestational age reduced sepsis risk by 20%, while each day of parenteral nutrition increased risk by 22%.
Introduction:
Healthcare associated infections in very low birth weight infants are associated with significant morbidity and mortality and are also a cause of increased length of stay and hospital costs. The objective of this study was to evaluate the rate of healthcare-associated sepsis and associated risk factors in very low birth weight infants.
Material And Methods:
Retrospective observational study including very low birth weight infants hospitalized in a Neonatal Intensive Care Unit during ten years (2005-2014). We evaluated the association between several risk factors and healthcare-associated sepsis.
Results:
461 very low birth weight infants were admitted. There were 110 episodes of HS in 104 very low birth weight infants and 53 episodes of sepsis associated with central vascular catheter. The density of the sepsis was 7.5/1 000 days of hospitalization and the density of central vascular catheter - associated sepsis was 22.6/1 000 days of use. The infants with HS had lower average birth weight and gestational age (959 ± 228 g vs 1191 ± 249 g and 27.6 ± 2 vs 29.8 ± 2.2 weeks), p < 0.001. After adjusting for birth weight and gestational age we verified an association between healthcare-associated sepsis and antibiotic therapy in D1, the duration of parenteral nutrition and central vascular catheter. After logistic regression only the gestational age and duration of parenteral nutrition remained as independent significant risk factors for healthcare-associated sepsis.
Discussion:
The independent factors for healthcare-associated sepsis are gestational age and duration of parenteral nutrition.
Conclusion:
For each extra week on gestational age the risk declined in 20% and for each day of NP the risk increased 22%.
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