Neurodevelopmental Outcome after Culture-Proven or So-Called Culture-Negative Sepsis in Preterm Infants

Area of Science:

• Neonatal care
• Neurodevelopmental outcomes
• Infectious diseases in neonates

Background:

• Prematurity is a significant risk factor for long-term neurological deficits.
• Neonatal sepsis is a common complication in premature infants, potentially impacting neurodevelopment.
• Understanding the specific impact of sepsis type on neurodevelopmental outcomes is critical.

Purpose of the Study:

• To compare neurodevelopmental outcomes in preterm neonates with and without sepsis.
• To investigate the association between different types of neonatal sepsis (culture-proven, culture-negative) and severe functional disability (SFD).
• To identify risk factors for SFD in high-risk preterm infants.

Main Methods:

• Retrospective case-control study of preterm infants (birth weight < 1500g or gestational age ≤ 30 weeks).
• Comparison of short-term outcomes, brain MRI findings, and SFD at 24 months between infants with sepsis and controls.
• Statistical analysis using chi-squared and Mann-Whitney U tests, with multivariate logistic regression.

Main Results:

• Infants with all sepsis (n=76) and culture-proven sepsis (n=33) showed a higher incidence of SFD compared to controls (n=76).
• Culture-negative sepsis (n=43) was not significantly associated with an increased risk of SFD.
• Multivariate analysis identified intraventricular hemorrhage and all sepsis as significant predictors of SFD.

Conclusions:

• Both all sepsis and culture-proven sepsis are associated with severe functional disability in preterm infants.
• Culture-negative sepsis did not demonstrate an increased risk for SFD in this cohort.
• Preventing culture-proven sepsis in neonatal intensive care units is a priority to improve long-term neurodevelopmental outcomes.