Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units
Singapore medical journal
;
: 144-152, 2016.
Article
in English
| WPRIM
| ID: wpr-296460
ABSTRACT
<p><b>INTRODUCTION</b>This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR).</p><p><b>METHODS</b>This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture.</p><p><b>RESULTS</b>Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition.</p><p><b>CONCLUSION</b>Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Intensive Care Units, Neonatal
/
Epidemiology
/
Incidence
/
Survival Rate
/
Retrospective Studies
/
Risk Factors
/
Follow-Up Studies
/
Sepsis
/
Infant, Very Low Birth Weight
/
Infant, Premature, Diseases
Type of study:
Etiology study
/
Incidence study
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Observational study
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Prognostic study
/
Risk factors
Limits:
Humans
/
Infant, Newborn
Country/Region as subject:
Asia
Language:
English
Journal:
Singapore medical journal
Year:
2016
Type:
Article
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