Table 3. Mortality and late onset sepsis (LOS) in the first 120 days of life in VLBW infants with early onset sepsis (EOS) compared with other VLBW infants in the NRN born Sept. 1, 1998-Dec. 31, 2009 who survived > 3 days—excluding infants without EOS who received antibiotics.
| Outcome, n (%) | Infants with EOS | Infants without EOS who did not receive AB for 5+ days starting in first 72 h1/ | Adjusted RR (95% CI) for outcome, infants with vs. without EOS 2/ |
Adjusted p-value 2/ |
|---|---|---|---|---|
| Infants who survived > 3 days | N=504 | N=20357 | ||
|
| ||||
| Death or LOS by 120 days (all pathogens) |
||||
| Overall | 196/504 (39) | 4625/20357 (23) | 1.03 (0.93-1.15) | 0.59 |
| By gestational age (weeks) 3/ | ||||
| <25 | 76/122 (62) | 861/1274 (68) | 0.88 (0.76-1.02) | 0.09 |
| 25-28 | 105/273 (38) | 2708/8487 (32) | 1.12 (0.97-1.30) | 0.12 |
| 29+ | 15/109 (14) | 1055/10592 (10) | 1.27 (0.79-2.04) | 0.32 |
|
| ||||
| Death or LOS by 120 days (non-CoNS pathogens) |
||||
| Overall | 148/504 (29) | 3089/20357 (15) | 1.12 (0.98-1.28) | 0.12 |
| By gestational age (weeks) 3/ | ||||
| <25 | 64/122 (52) | 675/1274 (53) | 0.97 (0.81-1.15) | 0.69 |
| 25-28 29+ | 72/273 (26) 12/109 (11) | 1757/8487 (21) 656/10592 (6) | 1.20 (0.99-1.47) 1.68 (0.98-2.88) | 0.065 0.061 |
|
| ||||
| Death by 120 days | ||||
| Overall | 89/504 (18) | 1264/20357 (6) | 1.45 (1.19-1.75) | 0.001 |
| By gestational age (weeks) 3/ | ||||
| <25 | 40/122 (33) | 376/1274 (30) | 1.08 (0.84-1.38) | 0.56 |
| 25-28 | 40/273 (15) | 666/8487 (8) | 1.73 (1.30-2.30) | <0.001 |
| 29+ | 9/109 (8) | 221/10592 (2) | 3.88 (2.04-7.39) | <0.001 |
|
| ||||
| Infants who survived to 120 days4/ | N=412 | N=18979 | ||
|
| ||||
| LOS by discharge/transfer/120 days (all pathogens) |
||||
| Overall | 107/412 (26) | 3353/18979 (18) | 0.90 (0.77-1.05) | 0.17 |
| By gestational age (weeks) 3/ | ||||
| <25 | 36/81 (44) | 484/891 (54) | 0.78 (0.60-1.01) | 0.057 |
| 25-28 | 65/231 (28) | 2038/7778 (26) | 1.01 (0.82-1.24) | 0.93 |
| 29+ | 6/100 (6) | 831/10307 (8) | 0.67 (0.31-1.46) | 0.32 |
|
| ||||
| LOS by discharge/transfer/120 days (non-CoNS pathogens) |
||||
| Overall | 59/412 (14) | 1821/18979 (10) | 0.91 (0.72-1.15) | 0.42 |
| By gestational age (weeks) 3/ | ||||
| <25 | 24/81 (30) | 298/891 (33) | 0.88 (0.61-1.26) | 0.47 |
| 25-28 | 32/231 (14) | 1090/7778 (14) | 0.97 (0.70-1.35) | 0.85 |
| 29+ | 3/100 (3) | 433/10307 (4) | 0.66 (0.22-2.03) | 0.47 |
Information about antibiotics received in the first 72 hours after birth was missing for 25 infants who were excluded. Among those with information, 40% (13510/33867) of infants without EOS who received antibiotics for ≥ 5 days started within the first 72 hours were excluded.
RR=relative risk, CI=confidence interval. Overall relative risks and CIs were from modified Poisson regression models fit to each outcome that included study center, gestational age (<25, 25-28, 29+ w), BW (401-750, 751-1000, 1001-1250, 1251-1500), male sex, race/ethnicity (non-Hispanic black, non-Hispanic white, Hispanic, other) and an EOS indicator. RRs and CIs in each GA group were from a model that included the interaction between GA and EOS group in addition to the covariates listed. P-values are by the Score chi-square (overall) or Wald chi-square (by GA) from these models.
Gestational age was missing for 4 infants without EOS who did not receive antibiotics as described (3 among survivors to 120 days).
Survivors to 120 days were defined as infants who had been discharged to home from the birth hospital by 120 days of life, infants who remained in the birth hospital at 120 days, and infants who had been transferred to another hospital or chronic care facility before 120 days who remained in the transfer hospital or had been discharged to home by 120 days. 117 infants with incomplete status information after transfer before 120 days (unknown final status or discharged to home with missing discharge date) were excluded.