Abstract:
BACKGROUND:Neonatal bloodstream infection (BSI) is the most important cause of morbidity and mortality in the neonatal intensive care unit (NICU). Although most neonatal BSIs are primary bacteremia, some are associated with a focus of infection. This distinction is not well characterized. METHODS:All patients with neonatal late-onset sepsis (LOS) between January 2006 and December 2013 were enrolled. LOS was categorized as a BSI with a concurrent focus of infection if LOS occurred before or within 24 h after the diagnosis of a specific infectious entity, and as "primary bacteremia" if no concurrent focus of infection was identified. Data concerning demographics, hospital course, microbiology, and outcomes were compared via univariate and multivariate analyses. RESULTS:Of 948 episodes of neonatal LOS, 781 (82.4%) were primary bacteremia, whereas 167 (17.6%) were associated with a known focus of infection, including meningitis (n = 51, 5.4%), ventilator-associated pneumonia (VAP) (n = 36, 3.8%), catheter-related bloodstream infections (n = 57, 6.0%), and necrotizing enterocolitis (NEC) (n = 21, 2.2%). The majority of NEC-associated BSIs were caused by gram-negative bacilli (85.7%). Group B streptococcus accounted for nearly one-third of all meningitis cases (29.4%). Although sepsis-attributable mortality was comparable between primary bacteremia and neonatal BSIs with a focus of infection, neonatal BSIs with meningitis, VAP, and NEC had significantly higher rates of infectious complications. The independent risk factors of sepsis-attributable mortality were infectious complications (Odds ratio [OR] 6.98; 95% confidence interval [CI] 3.64-13.39, P < 0.001); history of one or more than one previous episode(s) of BSI (OR 2.40 and 7.40; 95% CI 1.21-4.74 and 3.70-14.78, P = 0.012 and <0.001, respectively); and underlying secondary pulmonary hypertension in neonates (OR 4.77; 95% CI 1.91-11.96, P = 0.001). CONCLUSIONS:A considerable proportion of neonatal LOS can be associated with known infectious foci in the NICU. The microbiologic etiology of neonatal LOS with a concurrent focus of infection is significantly different from that of primary bacteremia. Neonatal BSIs with concurrent meningitis, VAP, or NEC are significantly more likely to have infectious complications. This association independently leads to sepsis-attributable mortality.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Wu IH,Tsai MH,Lai MY,Hsu LF,Chiang MC,Lien R,Fu RH,Huang HR,Chu SM,Hsu JFdoi
10.1186/s12879-017-2574-7subject
Has Abstractpub_date
2017-07-03 00:00:00pages
465issue
1issn
1471-2334pii
10.1186/s12879-017-2574-7journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Even though remarkable progress for diagnostics of pulmonary TB has been made, it is still a challenge to establish a definitive diagnosis for extrapulmonary TB (EPTB) in clinical practice. Among all the presentations of EPTB, cold abscesses are unusual and deceptive, which are often reported in the chest wa...
journal_title:BMC infectious diseases
pub_type: 杂志文章,评审
doi:10.1186/s12879-020-05137-w
更新日期:2020-06-12 00:00:00
abstract:BACKGROUND:It is unclear whether appropriate empiric antimicrobial therapy improves outcomes in patients with bacteremia due to Escherichia coli or Klebsiella. The objective of this study is to assess the impact of appropriate empiric antimicrobial therapy on in-hospital mortality and post-infection length of stay in p...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-8-116
更新日期:2008-09-15 00:00:00
abstract:BACKGROUND:Fear of TB infection is rooted in historical and social memories of the disease, marked by stigma, segregation and exclusion. Healthcare workers (HCWs) face these same fears today, and even seek to hide their TB status when infected. This study sought to investigate factors associated with HCWs fears of acqu...
journal_title:BMC infectious diseases
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12879-019-4115-z
更新日期:2019-05-28 00:00:00
abstract:BACKGROUND:The risk of life-threatening and invasive infections with encapsulated bacteria is increased in patients with hyposplenia or asplenia. We report a case of recurrent invasive pneumococcal meningitis in a woman with previous unknown hyposplenia. She was vaccinated after the first episode of meningitis and deve...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-0883-2
更新日期:2015-04-02 00:00:00
abstract:BACKGROUND:Benefits using the 13-valent pneumococcal conjugate vaccine (PCV13) in adults are controversial. This study investigated clinical effectiveness of PCV13 vaccination in preventing hospitalisation from pneumonia among middle-aged and older adults. METHODS:Population-based cohort study involving 2,025,730 indi...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3096-7
更新日期:2018-04-27 00:00:00
abstract:BACKGROUND:Risk of pneumocystosis after discontinuation of primary or secondary prophylaxis among HIV-infected patients before CD4 counts increase to >==200 cells/microL (early discontinuation) after receiving highly active antiretroviral therapy (HAART) is rarely investigated. METHODS:Medical records of 660 HIV-infec...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-10-126
更新日期:2010-05-21 00:00:00
abstract:BACKGROUND:Refugees in sub-Saharan Africa face both the risk of HIV infection and barriers to HIV testing. We conducted a pilot study to determine the feasibility and acceptability of home-based HIV testing in Nakivale Refugee Settlement in Uganda and to compare home-based and clinic-based testing participants in Nakiv...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3238-y
更新日期:2018-07-16 00:00:00
abstract:BACKGROUND:Antimicrobial overuse and misuse of broad-spectrum antibiotics increases the risk for antimicrobial resistance. Investigating unwarranted variation in antibiotic prescription has therefore gained global priority. METHODS:We examined recent time trends in the utilization of narrow- and broad-spectrum antibio...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-019-3964-9
更新日期:2019-04-24 00:00:00
abstract:BACKGROUND:Patients with HIV/AIDS on Antiretroviral Therapy (ART) suffer from physical, psychological and spiritual problems. Despite international policy explicitly stating that a multidimensional approach such as palliative care should be delivered throughout the disease trajectory and alongside treatment, the effect...
journal_title:BMC infectious diseases
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2334-12-288
更新日期:2012-11-06 00:00:00
abstract:BACKGROUND:The study of the endotoxin tolerance phenomenon in light of the recently defined roles of mast cells and toll-like receptors as essential components of the innate immune response and as orchestrators of acquired immunity may reveal potentially useful mechanisms of immunomodulation of infectious and allergic ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-10-240
更新日期:2010-08-14 00:00:00
abstract:BACKGROUND:Staphylococcus aureus bacteraemia (SAB) causes considerable morbidity and mortality in children. Despite this, its epidemiology and risk factors are poorly understood, with minimal paediatric clinical trial data available to guide clinicians in management. We conducted a pilot study to characterise SAB and v...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3312-5
更新日期:2018-08-10 00:00:00
abstract:BACKGROUND:We estimated the nationwide burden of nosocomial S. aureus bloodstream infection (SA-BSI), a major cause of nosocomial infection, in South Korea. METHODS:To evaluate the nationwide incidence of nosocomial SA-BSI, cases of SA-BSI were prospectively collected from 22 hospitals with over 500 beds over 4?months...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-014-0590-4
更新日期:2014-11-14 00:00:00
abstract:BACKGROUND:Hospital-based surveillance for pneumococcal meningitis has been conducted since January 1996 in the city of Salvador, Brazil. The purpose of this study was to describe the temporal evolution of Penicillin Non-Susceptible Streptococcus pneumoniae (PNSSP) in regards to serotype distributions and clonal divers...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1049-y
更新日期:2015-07-30 00:00:00
abstract:BACKGROUND:Patients with HIV infection are at risk of co-infection with HBV, as the routes of transmission are shared and thus immunization with HBV vaccine could be protective in them. The aim of the present study was to assess the efficacy of recombinant vaccine in treatment-naive HIV positive patients and healthy co...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-6-65
更新日期:2006-03-30 00:00:00
abstract:BACKGROUND:Infectious disease prevention and control strategies require a coordinated, transnational approach. To establish core capacities of the International Health Regulations (IHR), the World Health Organization (WHO) developed the Integrated Diseases Surveillance and Response (IDSR) strategy. Epidemic-prone Lassa...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-019-4240-8
更新日期:2019-07-10 00:00:00
abstract:BACKGROUND:Hepatitis B virus (HBV) infection is a high-risk factor of hepatocellular carcinoma (HCC). Cellular immune responses are essential for HCC development, and the CD4+ and CD8+ T subtypes are identified as the primary anti-tumor immune cells. In the study, we investigated the effect and mechanism of amygdalin i...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05713-0
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:Beijing genotype strains are the most predominant strains in China. The aim of this study was to explore risk factors and clinical phenotypes associated with infection with Beijing genotype strains among tuberculosis patients in China. METHODS:Using data and strains derived from the first Chinese national d...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-12-354
更新日期:2012-12-17 00:00:00
abstract:BACKGROUND:Varicella is normally a self-limited childhood disease caused by varicella-zoster virus infection. However, it sometimes causes severe diseases, especially in immunocompromised individuals. We report a case of severe varicella in a young woman. CASE PRESENTATION:A 19-year-old woman presented to the emergenc...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-019-4716-6
更新日期:2020-01-17 00:00:00
abstract:BACKGROUND:The impacts of genetic polymorphisms on drug resistance mutations (DRMs) among various HIV-1 subtypes have long been debated. In this study, we aimed to analyze the natural polymorphisms and acquired DRM profile in HIV-1 CRF01_AE-infected patients in a large first-line antiretroviral therapy (ART) cohort in ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-4808-3
更新日期:2020-02-26 00:00:00
abstract:BACKGROUND:The pandemic influenza A (H1N1) virus emerged during 2009 and has spread worldwide. This virus can cause injuries to the lungs, liver, and heart. However, data regarding whether this influenza virus can affect pancreatic islets are limited. We investigated the effects of influenza A (H1N1) pneumonia on fasti...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-11-104
更新日期:2011-04-21 00:00:00
abstract:BACKGROUND:The differential expression of virulence genes is often used by microbial pathogens in adapting to the environment of their host. The differential expression of such sets of genes can be regulated by RNA polymerase sigma factors. Some sigma factors are differentially expressed, which can provide a means to i...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-3-15
更新日期:2003-07-11 00:00:00
abstract:BACKGROUND:Low density Plasmodium falciparum infections, below the microscopic detection limit, may play an important role in maintaining malaria transmission in low endemic areas as well as contribute to the maintenance of acquired immunity. Little is known about factors influencing the occurrence of sub-microscopic p...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-9-69
更新日期:2009-05-21 00:00:00
abstract:BACKGROUND:Chronic kidney disease, including end-stage renal disease, has been identified as a possible risk factor for primary septicemia and wound infection by Vibrio vulnificus. However, cases of severe septicemia, necrotizing fasciitis, and peritonitis caused by V. vulnificus in patients undergoing continuous ambul...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1163-x
更新日期:2015-10-14 00:00:00
abstract:BACKGROUND:We analyzed the results of a 3-year surveillance study on the epidemiological and clinical characteristics of healthcare associated-infections (HAIs) in elderly inpatients in a large tertiary hospital in China. METHODS:Real-time surveillance was performed from January 1, 2015 to December 31, 2017. All HAIs ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-4840-3
更新日期:2020-02-10 00:00:00
abstract:BACKGROUND:Procalcitonin (PCT) has become a commonly used serum inflammatory marker. Our aim was to describe the kinetics and usefulness of serial post-operative PCT measurements to detect bacterial infection in a cohort of children immediately after pediatric liver transplantation (pLT). METHODS:We performed a retros...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-017-2234-y
更新日期:2017-02-15 00:00:00
abstract:BACKGROUND:Dengue is the most widespread mosquito-borne viral disease of public health concern. In some patients, endothelial cell and platelet dysfunction lead to life-threatening hemorrhagic dengue fever or dengue shock syndrome. Prognostication of disease severity is urgently required to improve patient management. ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1271-7
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:On 18 August 2015, Kyegegwa District reported eight deaths during a measles outbreak to the Uganda Ministry of Health (MoH). We investigated this death cluster to verify the cause, identify risk factors, and inform public health interventions. METHODS:We defined a probable measles case as onset of fever and...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-017-2558-7
更新日期:2017-07-03 00:00:00
abstract:BACKGROUND:Previous controlled studies on the effect of non-pharmaceutical interventions (NPI) - namely the use of facemasks and intensified hand hygiene - in preventing household transmission of influenza have not produced definitive results. We aimed to investigate efficacy, acceptability, and tolerability of NPI in ...
journal_title:BMC infectious diseases
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2334-12-26
更新日期:2012-01-26 00:00:00
abstract:BACKGROUND:Regardless of chronic treatment with antiretroviral therapy (ART), the switching rate for ART regarding anchor drugs has not been articulated in real-world clinical-settings in Japan. We assessed switch rates and time-to-switch of ART regimens according to anchor drug classes (integrase strand transfer inhib...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-019-4129-6
更新日期:2019-06-10 00:00:00
abstract:BACKGROUND:In France, 1/3 HIV-infected patients is diagnosed at an advanced stage of the disease. We describe missed opportunities for earlier HIV testing in newly-HIV-diagnosed patients. METHODS:Cross sectional study. Adults living in France for ≥1 year, diagnosed with HIV-infection ≤6 months earlier, were included f...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-13-200
更新日期:2013-05-02 00:00:00