Details

Autor(en) / Beteiligte

• Chu, Shih-Ming
• Hsu, Jen-Fu
• Lee, Chiang-Wen
• Lien, Reyin
• Huang, Hsuan-Rong
• Chiang, Ming-Chou
• Fu, Ren-Huei
• Tsai, Ming-Horng
• Schlievert, Patrick M.

Titel

Neurological complications after neonatal bacteremia: the clinical characteristics, risk factors, and outcomes

Ist Teil von

• PloS one, 2014-11, Vol.9 (11), p.e105294-e105294

Ort / Verlag

United States: Public Library of Science

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Neonates with bacteremia are at risk of neurologic complications. Relevant information warrants further elucidation. This was a retrospective cohort study of neonates with bacteremia-related neurologic complications (BNCs) in a tertiary-level neonatal intensive care unit (NICU). A systemic chart review was performed conducted to identify clinical characteristics and outcomes. A cohort of related conditions was constructed as the control group. Logistic regression analysis was used to identify independent risk factors for BNC. Of 1037 bacteremia episodes, 36 (3.5%) had BNCs. Twenty-four cases of BNCs were related to meningitis, five were presumed meningitis, and seven occurred after septic shock. The most common causative pathogens were Group B streptococcus (41.7%) and E. coli (16.7%). The major BNCs consisted of seizures (28), hydrocephalus (20), encephalomalacia (11), cerebral infarction (7), subdural empyema (6), ventriculitis (8), and abscess (4). Eight (22.8%) neonates died and six (16.7%) were discharged in critical condition when the family withdrew life-sustaining treatment. Among the 22 survivors, eight had neurologic sequelae upon discharge. After multivariate logistic regression analysis, neonates with meningitis caused by Group B streptococcus (adjusted odds ratio [OR]: 8.90, 95% confidence interval [CI]: 2.20-36.08; p = 0.002) and combined meningitis and septic shock (OR, 5.94; 95% CI: 1.53-23.15; p = 0.010) were independently associated with BNCs. Neonates with bacteremia-related neurologic complications are associated with adverse outcomes or sequelae. Better strategies aimed at early detection and reducing the emergence of neurologic complications and aggressive treatment of Group B streptococcus sepsis are needed in neonates with meningitis and septic shock.