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Published on: November 20, 2015
From Gram-Negative Neonatal Sepsis to Neurodevelopmental Impairment: A Retrospective Cohort Study in Preterm Infants
Mihaela Zaharie1,2,3,4,5, Marioara Boia2,3,5, Aniko Manea2,3,5
1Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Children (Basel, Switzerland)
|July 28, 2026
Summary
Gram-negative neonatal sepsis in preterm infants leads to significant mortality and long-term neurodevelopmental impairment. Lower gestational age is a key predictor of poor outcomes, highlighting the need for early intervention.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Neurodevelopmental Pediatrics
Background:
- Gram-negative neonatal sepsis is a major cause of illness and death in preterm infants.
- The link between early sepsis severity and long-term neurodevelopmental issues is not fully understood.
Purpose of the Study:
- To define the characteristics of Gram-negative sepsis in preterm infants.
- To assess the short-term and 18-24 month neurodevelopmental effects of this condition.
Main Methods:
- Retrospective cohort study of preterm infants with culture-proven Gram-negative sepsis (early-onset sepsis [EOS] and late-onset sepsis [LOS]).
- Data collected included clinical, microbiological, therapeutic, and laboratory findings.
- Survivors underwent neurodevelopmental assessment at 18-24 months corrected age using Bayley Scales.
Main Results:
- Late-onset sepsis was more common; Klebsiella pneumoniae was the most frequent pathogen.
- In-hospital mortality was 26.0%; common complications included intraventricular hemorrhage and necrotizing enterocolitis.
- 38.0% of survivors had neurodevelopmental impairment, particularly in language and cognitive domains. Lower gestational age predicted mortality and impairment.
Conclusions:
- Gram-negative neonatal sepsis in preterm infants results in high mortality, severe complications, and significant neurodevelopmental impairment.
- Lower gestational age is a critical independent predictor of adverse short- and long-term outcomes.
- Early detection, targeted treatment, and structured follow-up are crucial for this vulnerable population.
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