Risk Factors and Prevention of Late-onset Bacterial Sepsis in Very Preterm Infants / 中山大学学报(医学科学版)

ABSTRACT

ObjectiveTo investigate the clinical features and high risk of very preterm infants with late-onset bacterial sepsis，so as to propose feasible prevention and treatment suggestions． MethodsTotally 94 very preterm infants with late-onset bacterial sepsis from the Neonatology Department of Women’s Hospital of Jiangnan University were recruited from February， 2012 to January， 2024. Their clinical data， including the perinatal situation， clinical symptoms， pathogens， risk factors and treatment， were collected and analyzed. ResultsThe incidence rate of very preterm infants with late-onset bacterial sepsis were 8.40 for 100 live birth babies. The major pathogens of the infections among these very premature infants included gram-positive bacteria （71.1%）. Logistic regression analysis showed that long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）， and vaginal delivery were high risk factors of very preterm infants with late-onset bacterial sepsis， the relative risk （OR） values were 2.787， 4.243， 3.033 and 2.174， respectively. ConclusionThe gram-positive bacteria are the main pathogens of late-onset bacterial sepsis in very preterm infants. Long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）and vaginal delivery are high risk factors of very preterm infants with late-onset bacterial sepsis. The incidence of late-onset bacterial sepsis in very preterm infants can be reduced by strengthening perinatal management， shortening the time of antibiotic application and reducing invasive operations.