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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Neurodevelopmental outcome at 2 years of age in preterm infants with late-onset sepsis
I A Zonnenberg1, E M van Dijk-Lokkart2, F A M van den Dungen3
1Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. i.zonnenberg@vumc.nl.
Insights
Late-onset sepsis in preterm infants did not affect neurodevelopment at 2 years corrected age. However, coagulase-negative staphylococci sepsis was linked to better cognitive outcomes compared to other infections.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Infectious Diseases
Background:
- Late-onset sepsis (LOS) in preterm infants is a significant concern, often linked to adverse neurodevelopmental outcomes.
- Understanding the specific impact of different pathogens and infection timing is crucial for improving long-term prognoses.
Purpose of the Study:
- To investigate the neurodevelopmental effects of sepsis occurring after 72 hours of life in preterm infants.
- To compare cognitive, psychomotor, and language development between infants with and without proven late-onset sepsis.
- To analyze the influence of specific bacterial agents, particularly coagulase-negative staphylococci, on neurodevelopmental outcomes.
Main Methods:
- A prospective cohort study included preterm infants (<32 weeks gestational age and/or <1500g).
- Neurodevelopment was assessed at 2 years corrected age using Bayley's Scales of Infant Development-II, Lexilijst, and behavior checklists.
- Blood cultures were used to confirm infections, with 85 out of 117 infants experiencing proven infections.
Main Results:
- No significant differences in cognitive, motor, or behavioral scores were observed between infants with and without proven late-onset sepsis.
- A significant difference in composite cognitive scores was found when comparing three groups: coagulase-negative staphylococci, other causal agents, and no infection (p=0.016).
- Infants with coagulase-negative staphylococci sepsis showed better cognitive outcomes compared to those with other bacterial agents (p=0.007).
Conclusions:
- In this cohort, proven late-onset sepsis did not result in significant differences in neurodevelopmental outcomes at 2 years corrected age compared to no proven infection.
- Coagulase-negative staphylococci sepsis was associated with better cognitive outcomes than sepsis caused by other agents.
- Larger cohort studies with robust control groups are needed to confirm these findings.
Abstract:
Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. This prospective cohort study aims to establish the effect of sepsis after 72 h of life on cognitive, psychomotor, and language development of preterm infants (below 32 weeks gestational age and/or below 1500 g). At 2 years corrected age, neurodevelopmental outcome was tested using Bayley's Scales of Infant Development-II, Lexilijst (lexical development questionnaire), and behavior checklists. Of 117 patients included, 85 experienced blood culture-proven infection. Coagulase-negative staphylococci were responsible for 55% of the episodes. No significant differences were found in cognitive, motor, and behavioral scores or lexiquotient comparing patients with versus no proven infection. When comparing three groups (coagulase-negative staphylococci, other, and negative blood culture), a significant difference was found in composite cognitive scores (p = 0.016), in favor of the coagulase-negative staphylococci group versus other causal agent group (p = 0.007). No significant differences were found in other subscales.Conclusion: In this cohort, no differences were found in neurodevelopmental outcome at 2 years corrected age between proven and no proven infection groups; confirmation in larger cohorts with a control group is needed. Patients encountering coagulase-negative staphylococci sepsis showed a significant better cognitive outcome compared to other causal agents. What is Known: • Late-onset sepsis is associated with impaired neurodevelopmental outcome in preterm infants. What is New: • Preterm infants encountering late-onset sepsis by coagulase-negative staphylococci show a better cognitive outcome in comparison to other causal infectious agents in this cohort. • No differences were found in neurodevelopment at 2 years of age in preterm infants with suspected lateonset sepsis, between proven and no proven infection groups. Confirmation is needed in larger cohorts with a substantial control group.
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