Neonatal sepsis in alloimmune hemolytic disease of the fetus and newborn: A retrospective cohort study of 260 neonates.
Transfusion
; 63(1): 117-124, 2023 01.
Article
em En
| MEDLINE
| ID: mdl-36334304
ABSTRACT
BACKGROUND:
Among neonates with hemolytic disease of the fetus and newborn (HDFN), we aimed to describe the frequency of central-line use, indications for insertion, and incidence of confirmed and suspected sepsis, including antibiotic treatment over a 10-year surveillance period. STUDY DESIGN ANDMETHODS:
All neonates with HDFN admitted to our neonatal intensive care unit between January 2012 and December 2021 were included in this retrospective, cohort study. Annual proportions of infants with a central-line and central-line-associated bloodstream infection (CLABSI) rates (per 1000 central-line days and per 100 infants) were evaluated. Numbers of confirmed and suspected early- and late-onset sepsis episodes were assessed over the entire study period.RESULTS:
Of the 260 included infants, 25 (9.6%) were evaluated for suspected sepsis, with 16 (6.2%) having ≥1 confirmed sepsis episode. A total of 123 central-lines were placed in 98 (37.7%) neonates, with impending exchange transfusion (ET) being the most frequent indication. Of the 34 (34.7%) neonates in whom a central-line was placed due to impending ET, 11 (32.4%) received no ET. Overall CLABSI incidence was 13.58 per 1000 central-line days. Neonates with a central-line had a higher risk for confirmed late-onset infection (RR 1.11, 95% CI 1.04-1.20) and sepsis work-up (RR 1.10, 95% CI 1.03-1.17) compared to infants without a central-line.CONCLUSIONS:
Sepsis incidence among neonates with HDFN remains high, in particular in those with a central-line. Considering the substantial proportion of neonates with a central-line without eventual ET, central-line placement should be delayed until the likelihood of ET is high.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sepse
/
Eritroblastose Fetal
/
Sepse Neonatal
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
/
Newborn
Idioma:
En
Revista:
Transfusion
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Holanda