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- Title
Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units.
- Authors
Nem-Yun Boo; Irene Guat-Sim Cheah; Boo, Nem-Yun; Cheah, Irene Guat-Sim
- Abstract
<bold>Introduction: </bold>This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR).<bold>Methods: </bold>This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture.<bold>Results: </bold>Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition.<bold>Conclusion: </bold>Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis.
- Subjects
MALAYSIA; SEPTICEMIA in children; LOW birth weight; SEPSIS; NEONATAL intensive care; CHILDBIRTH; PATIENTS; COMPARATIVE studies; PREMATURE infant diseases; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SURVIVAL; EVALUATION research; NEONATAL intensive care units; DISEASE incidence; RETROSPECTIVE studies
- Publication
Singapore Medical Journal, 2016, Vol 57, Issue 3, p144
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2016056