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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.
Artigo em Inglês | 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>
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Unidades de Terapia Intensiva Neonatal / Epidemiologia / Incidência / Taxa de Sobrevida / Estudos Retrospectivos / Fatores de Risco / Seguimentos / Sepse / Recém-Nascido de muito Baixo Peso / Doenças do Prematuro Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos / Recém-Nascido País/Região como assunto: Ásia Idioma: Inglês Revista: Singapore medical journal Ano de publicação: 2016 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Unidades de Terapia Intensiva Neonatal / Epidemiologia / Incidência / Taxa de Sobrevida / Estudos Retrospectivos / Fatores de Risco / Seguimentos / Sepse / Recém-Nascido de muito Baixo Peso / Doenças do Prematuro Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos / Recém-Nascido País/Região como assunto: Ásia Idioma: Inglês Revista: Singapore medical journal Ano de publicação: 2016 Tipo de documento: Artigo