Preterm and Term Infants Evaluated for Sepsis: Differences in Management and Clinical Outcomes.

Area of Science:

• Neonatal Medicine
• Pediatric Infectious Diseases
• Clinical Pediatrics

Background:

• Sepsis evaluation and management in young preterm infants are not well-defined.
• Differences in practice patterns and outcomes between preterm and term infants with suspected sepsis require description.

Purpose of the Study:

• To compare diagnostic evaluation, management, and clinical outcomes of young preterm infants with age-matched term infants presenting with fever or hypothermia.
• To elucidate practice variations and outcomes in sepsis evaluation for these distinct infant populations.

Main Methods:

• Retrospective single-center study of infants aged 0-60 days evaluated for fever/hypothermia (2014-2019).
• Infants classified as preterm (32-36 6/7 weeks) or term (37-42 weeks).
• Comparison of diagnostic testing, hospitalization rates, ICU admission, and infection types.

Main Results:

• Preterm infants underwent more inflammatory marker testing and chest X-rays.
• Higher rates of bacteremia (5.9% vs 2.5%) and ICU admission (32% vs 5%) in preterm infants.
• Preterm infants had lower rates of viral infections but longer hospitalizations if hypothermic.

Conclusions:

• Preterm infants exhibit increased rates of bacteremia and require higher levels of care compared to term infants.
• These findings likely reflect the heightened risk of sepsis and comorbidities associated with preterm birth.
• Serious bacterial infections were more common in febrile preterm/term infants and hypothermic preterm infants.