Table 4.
Adverse outcomes in all VLBW infants
| Period 1 n = 727 | Period 2 n = 191 | p-valuea | |
|---|---|---|---|
| EOS (Culture confirmed infection at 0-3 days after birth), n (%) | 9 (1.2) | 2 (1.1) | 0.83 |
| Hours from birth when culture obtainedb, Median (IQR) | 0.6 (0.5-1.0) | 1.1 (1.0-1.1) | 0.41 |
| Hours from birth when first dose of antibiotic given, Median (IQR) | 1.8 (1.4-2.1) | 1.8 (1.6-2.0) | 0.81 |
| Organisms, n | - | ||
| Escherichia coli | 7 | 2 | |
| Klebsiella pneumoniae | 1 | 0 | |
| Candida albicans | 1 | 0 | |
| Culture confirmed infection at 4-7 days after birth, n (%) | 15 (2.1) | 3 (1.6) | 0.66 |
| Hours from birth when culture obtained, Median (IQR) | 138.2 (115.5-152.3) | 137.1 (121.3-139.7) | 0.59 |
| Hours from drawing culture and start of antibioticsc, Median (IQR) | 0.8 (0.2-6.8) | 1.0 (0.8-2.1) | 0.77 |
| Organisms, n | − | ||
| Coagulase-negative staphylococci | 9 | 2d | |
| Escherichia coli | 1 | 1 | |
| Klebsiella pneumoniae | 3 | 0 | |
| Staphylococcus aureus | 1 | 1 | |
| Enterobacter cloacae | 1 | 0 | |
| NEC/SIP ≤7 days after birth, n (%) | 7 (1.0) | 5 (2.6) | 0.07 |
| Indication for transfer ≤7 dayse, n (%) | 17 (2.3) | 6 (3.1) | 0.53 |
| Anomalies | 9 | 2 | |
| NEC/SIP | 7 | 4 | |
| Respiratory management | 1 | 0 | |
| Cause of death ≤7 daysf, n (%) | 19 (2.6) | 4 (2.1) | 0.68 |
| Extreme prematurity and respiratory failure | 12 | 3 | |
| EOS | 3 | 0 | |
| Intracranial hemorrhage | 3 | 0 | |
| Other | 1 | 1 | |
χ2 analysis not done when cell value is zero.
One EOS infant in Period 1 had culture drawn at 65 hours for onset of SIP (excluded from median).
Two infants in Period 1 were being treated with antibiotics when blood culture was obtained: in the first case, for cellulitis, and blood culture grew same the bacteria as wound culture; and in the second case, the blood culture was for test of cure in the setting of prior bacteremia.
This infant also grew Staphylococcus aureus from blood culture has been counted in both.
All infants who were transferred at ≤7 days after birth had a blood culture obtained, and all except 1 infant in Period 2 (negative blood culture after birth) had empiric antibiotics initiated ≤3 days after birth.
All infants who died at ≤7 days after birth had a blood culture obtained and empiric antibiotics initiated ≤3 days after birth. EOS, early-onset sepsis; IQR, interquartile range; NEC, necrotizing enterocolitis; SIP, spontaneous intestinal perforation; VLBW, very low birth weight (birth weight <1,500 grams).