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dc.contributor.authorHuncikova, Zuzana
dc.contributor.authorVatne, Anlaug
dc.contributor.authorStensvold, Hans Jørgen
dc.contributor.authorLang, Astri Maria
dc.contributor.authorStøen, Ragnhild
dc.contributor.authorBrigtsen, Anne Karin
dc.contributor.authorSalvesen, Bodil
dc.contributor.authorØymar, Knut Asbjørn Alexander
dc.contributor.authorRønnestad, Arild Erland
dc.contributor.authorKlingenberg, Claus Andreas
dc.description.abstractObjective To evaluate epidemiology and outcomes among very preterm infants (<32 weeks’ gestation) with culture-positive and culture-negative late-onset sepsis (LOS).<p> <p>Design Cohort study using a nationwide, population-based registry. <p>Setting 21 neonatal units in Norway. <p>Participants All very preterm infants born 1 January 2009–31 December 2018 and admitted to a neonatal unit. <p>Main outcome measures Incidences, pathogen distribution, LOS-attributable mortality and associated morbidity at discharge. <p>Results Among 5296 very preterm infants, we identified 582 culture-positive LOS episodes in 493 infants (incidence 9.3%) and 282 culture-negative LOS episodes in 282 infants (incidence 5.3%). Extremely preterm infants (<28 weeks’ gestation) had highest incidences of culture-positive (21.6%) and culture-negative (11.1%) LOS. The major causative pathogens were coagulase-negative staphylococci (49%), Staphylococcus aureus (15%), group B streptococci (10%) and Escherichia coli (8%). We observed increased odds of severe bronchopulmonary dysplasia (BPD) associated with both culture-positive (adjusted OR (aOR) 1.7; 95% CI 1.3 to 2.2) and culture-negative (aOR 1.6; 95% CI 1.3 to 2.6) LOS. Only culture-positive LOS was associated with increased odds of cystic periventricular leukomalacia (cPVL) (aOR 2.2; 95% CI 1.4 to 3.4) and severe retinopathy of prematurity (ROP) (aOR 1.8; 95% CI 1.2 to 2.8). Culture-positive LOS-attributable mortality was 6.3%, higher in Gram-negative (15.8%) compared with Gram-positive (4.1%) LOS, p=0.009. Among extremely preterm infants, survival rates increased from 75.2% in 2009–2013 to 81.0% in 2014–2018, p=0.005. In the same period culture-positive LOS rates increased from 17.1% to 25.6%, p<0.001. <p>Conclusions LOS contributes to a significant burden of disease in very preterm infants and is associated with increased odds of severe BPD, cPVL and severe ROP.en_US
dc.identifier.citationHuncikova, Vatne, Stensvold, Lang, Støen, Brigtsen, Salvesen, Øymar, Rønnestad, Klingenberg. Late-onset sepsis in very preterm infants in Norway in 2009-2018: A population-based study. Archives of Disease in Childhood: Fetal and Neonatal Edition. 2023en_US
dc.identifier.cristinIDFRIDAID 2131913
dc.relation.journalArchives of Disease in Childhood: Fetal and Neonatal Edition
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleLate-onset sepsis in very preterm infants in Norway in 2009-2018: A population-based studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US

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