Abrar Ahmad Chughtai, Naomi Spotswood, Tobias Strunk, Trisha Parmar, Tim Schindler, Himanshu Popat, Sharon Sue Wen Chow, Kei Lui
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Stratified by major surgery, the association between CA and bacterial LOS was evaluated.</p><p><strong>Results: </strong>Of 102,808 neonates, 37.7%, 32.8%, and 29.6% were born VPT, MPT, and FT, respectively. Among these, 3.4% VPT, 7.5% MPT, and 16.2% FT neonates had CA. VPT neonates had the highest LOS rate (11.1%), compared to MPT (1.8%) and FT (1.8%) neonates. LOS rates were higher in CA neonates than those without (8.2% versus 5.1% adjusted relative risk [aRR] 1.67, 95% confidence interval [CI]: 1.45-1.92). Neonates with surgery had a higher LOS rate (14.2%) than neonates without surgery (4.4%, p < 0.001). Among the neonates without surgery, CA neonates had consistently higher LOS rates than those without CA (VPT 14.3% vs. 9.6% [aRR 1.32, 95% CI: 1.11-1.57]; MPT 4% vs. 0.9% [aRR 4.45, 95% CI: 3.23-6.14]; and FT 2% vs. 0.7% [aRR 2.87, 95% CI: 1.97-4.18]). For the neonates with surgery, CAs were not associated with additional LOS risks.</p><p><strong>Conclusion: </strong>Overall, we reported higher rates of LOS in neonates with CA compared to those without CA. Regardless of gestation, CA was associated with an increased LOS risk among non-surgical neonates. Optimisation of infection prevention strategies for CA neonates should be explored. Future studies are needed to evaluate if the infection risk is caused by CA or associated complications.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between Congenital Anomalies and Late-Onset Bacterial Infections in Neonates Admitted to Neonatal Intensive Care Units in Australia and New Zealand: A Population-Based Cohort Study.\",\"authors\":\"Abrar Ahmad Chughtai, Naomi Spotswood, Tobias Strunk, Trisha Parmar, Tim Schindler, Himanshu Popat, Sharon Sue Wen Chow, Kei Lui\",\"doi\":\"10.1159/000540276\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Compromised neonatal intensive care unit neonates are at risk of acquiring late-onset infections (late-onset sepsis [LOS]). Neonates born with congenital anomalies (CAs) could have an additional LOS risk.</p><p><strong>Methods: </strong>Utilising the population-based Australian and New Zealand Neonatal Network data from 2007 to 2017, bacterial LOS rates were determined in very preterm (VPT, <32 week), moderately preterm (MPT, 32-36 weeks), and term (FT, 37-41 weeks) neonates with or without CA. Stratified by major surgery, the association between CA and bacterial LOS was evaluated.</p><p><strong>Results: </strong>Of 102,808 neonates, 37.7%, 32.8%, and 29.6% were born VPT, MPT, and FT, respectively. Among these, 3.4% VPT, 7.5% MPT, and 16.2% FT neonates had CA. VPT neonates had the highest LOS rate (11.1%), compared to MPT (1.8%) and FT (1.8%) neonates. LOS rates were higher in CA neonates than those without (8.2% versus 5.1% adjusted relative risk [aRR] 1.67, 95% confidence interval [CI]: 1.45-1.92). Neonates with surgery had a higher LOS rate (14.2%) than neonates without surgery (4.4%, p < 0.001). Among the neonates without surgery, CA neonates had consistently higher LOS rates than those without CA (VPT 14.3% vs. 9.6% [aRR 1.32, 95% CI: 1.11-1.57]; MPT 4% vs. 0.9% [aRR 4.45, 95% CI: 3.23-6.14]; and FT 2% vs. 0.7% [aRR 2.87, 95% CI: 1.97-4.18]). For the neonates with surgery, CAs were not associated with additional LOS risks.</p><p><strong>Conclusion: </strong>Overall, we reported higher rates of LOS in neonates with CA compared to those without CA. Regardless of gestation, CA was associated with an increased LOS risk among non-surgical neonates. Optimisation of infection prevention strategies for CA neonates should be explored. 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引用次数: 0
摘要
导言:新生儿重症监护室的新生儿有感染晚期败血症的风险(晚期败血症 [LOS])。患有先天性畸形(CA)的新生儿可能会增加晚期败血症的风险:利用基于人口的澳大利亚和新西兰新生儿网络 2007 年至 2017 年的数据,确定了有或没有 CA 的极早产儿(VPT,32 周)、中度早产儿(MPT,32-36 周)和足月新生儿(FT,37-41 周)的细菌 LOS 率。根据主要手术进行分层,评估了CA与细菌性LOS之间的关系:在 102,808 名新生儿中,37.7%、32.8% 和 29.6% 分别为 VPT、MPT 和 FT 新生儿。其中,3.4% 的 VPT 新生儿、7.5% 的 MPT 新生儿和 16.2% 的 FT 新生儿患有 CA。与 MPT(1.8%)和 FT(1.8%)新生儿相比,VPT 新生儿的 LOS 率最高(11.1%)。CA 新生儿的 LOS 率高于无 CA 的新生儿(8.2% 对 5.1%,调整相对风险 [aRR] 1.67,95% 置信区间 [CI]:1.45-1.92):1.45-1.92).接受手术的新生儿的 LOS 率(14.2%)高于未接受手术的新生儿(4.4%,P < 0.001)。在没有手术的新生儿中,CA新生儿的LOS率一直高于没有CA的新生儿(VPT 14.3% vs. 9.6% [aRR 1.32, 95% CI: 1.11-1.57];MPT 4% vs. 0.9% [aRR 4.45, 95% CI: 3.23-6.14];FT 2% vs. 0.7% [aRR 2.87, 95% CI: 1.97-4.18])。对于接受手术的新生儿来说,CA与额外的LOS风险无关:总体而言,与无 CA 的新生儿相比,有 CA 的新生儿的 LOS 率更高。无论妊娠时间长短,CA 都与非手术新生儿的 LOS 风险增加有关。应探讨如何优化CA新生儿的感染预防策略。未来的研究需要评估感染风险是由 CA 还是相关并发症引起的。
Association between Congenital Anomalies and Late-Onset Bacterial Infections in Neonates Admitted to Neonatal Intensive Care Units in Australia and New Zealand: A Population-Based Cohort Study.
Introduction: Compromised neonatal intensive care unit neonates are at risk of acquiring late-onset infections (late-onset sepsis [LOS]). Neonates born with congenital anomalies (CAs) could have an additional LOS risk.
Methods: Utilising the population-based Australian and New Zealand Neonatal Network data from 2007 to 2017, bacterial LOS rates were determined in very preterm (VPT, <32 week), moderately preterm (MPT, 32-36 weeks), and term (FT, 37-41 weeks) neonates with or without CA. Stratified by major surgery, the association between CA and bacterial LOS was evaluated.
Results: Of 102,808 neonates, 37.7%, 32.8%, and 29.6% were born VPT, MPT, and FT, respectively. Among these, 3.4% VPT, 7.5% MPT, and 16.2% FT neonates had CA. VPT neonates had the highest LOS rate (11.1%), compared to MPT (1.8%) and FT (1.8%) neonates. LOS rates were higher in CA neonates than those without (8.2% versus 5.1% adjusted relative risk [aRR] 1.67, 95% confidence interval [CI]: 1.45-1.92). Neonates with surgery had a higher LOS rate (14.2%) than neonates without surgery (4.4%, p < 0.001). Among the neonates without surgery, CA neonates had consistently higher LOS rates than those without CA (VPT 14.3% vs. 9.6% [aRR 1.32, 95% CI: 1.11-1.57]; MPT 4% vs. 0.9% [aRR 4.45, 95% CI: 3.23-6.14]; and FT 2% vs. 0.7% [aRR 2.87, 95% CI: 1.97-4.18]). For the neonates with surgery, CAs were not associated with additional LOS risks.
Conclusion: Overall, we reported higher rates of LOS in neonates with CA compared to those without CA. Regardless of gestation, CA was associated with an increased LOS risk among non-surgical neonates. Optimisation of infection prevention strategies for CA neonates should be explored. Future studies are needed to evaluate if the infection risk is caused by CA or associated complications.