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Distribution of Late-Onset Neonatal Sepsis Pathogens Differs in Inpatient and Outpatient Settings.

Abstract：

OBJECTIVE:We sought to examine pathogen distribution and clinical presentation of late-onset sepsis (LOS) at an urban tertiary care center. STUDY DESIGN:We performed a retrospective review of all culture-confirmed cases of LOS presenting to our institution from 2013 to 2017. Medical records were evaluated for demographic information, sepsis risk factors, encounter location, and clinical outcome. RESULTS:We identified 97 cases of LOS, with a median age at diagnosis of 25 days. The most common pathogens were Escherichia coli (22.7%), Staphylococcus aureus (17.5%), coagulase-negative staphylococci (12.4%), and Enterococcus faecalis (12.4%). Infections due to E. coli predominated in the outpatient setting (44%), whereas S. aureus and Gram-negative organisms other than E.coli were more frequently isolated from inpatients (21 and 24%, respectively). Gram-positive organisms were more common in infants delivered through cesarean section (p = 0.002) and were associated with more complications (p = 0.03). Escherichia coli LOS presented at an earlier age than S. aureus (15 vs. 32 days; p = 0.04). Of the 15 cases of meningitis, 40% did not have a positive blood culture. CONCLUSION:Pathogen distribution in our population was different from those previously reported, with a higher prevalence of S. aureus. Encounter location and age at presentation varied significantly by pathogen.

journal_name

Am J Perinatol

journal_title

American journal of perinatology

authors

Black CG,Tavares L,Stachel A,Ratner AJ,Randis TM

doi

10.1055/s-0038-1675643

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1136-1141

issue

11

eissn

0735-1631

issn

1098-8785

journal_volume

36

pub_type

杂志文章

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