Time trends in late-onset sepsis and meningitis in very low birth weight infants from 2000 to 2013: results from a Portuguese tertiary level Neonatal Intensive Care Unit

Abstract

Objective: To assess the evolution of the prevalence of late-onset sepsis (LOS) and meningitis and its predictors in a Portuguese tertiary level Neonatal Intensive Care Unit (NICU) during its participation in the Vermont Oxford Network (VON) between 2000 and 2013.

Methods: Descriptive retrospective study of all very low birth weight infants admitted to a level-III NICU between 2000 and 2013. Outborn infants, infants who died in the delivery room and neonates who died during the first 12 hours in NICU were excluded. Patients’ demographic characteristics and clinical data were collected. Data from neonates with and without LOS were compared.

Results: The prevalence of LOS significantly decreased from 56.3% between 2000 and 2004 to 26.5% between 2010 and 2013. Infants with a gestational age of 22-27 weeks had more LOS (65.6%) than neonates with 32-36 weeks (20.9%). Similarly, smaller infants (weighing ≤ 1,000 g) had more LOS (59.4%) than babies with a weight > 1,000 g (33.3%). LOS was significantly associated with a gestational age between 22 and 27 weeks, mechanical ventilation (MV), nasal CPAP, necrotizing enterocolitis and the use of steroids for bronchopulmonary dysplasia.

Conclusions: Preterm infants require many invasive devices to ensure their survival, such as MV, which greatly increases their infection risk. To minimize this risk, it is crucial to guarantee that better practices are followed, necessitating the use of regular audits. It is really important to know the data about LOS from our NICU, which allows sharing and comparison with peers in order to improve nosocomial infection prevention and control practices.