Perinatal risk factors of nosocomial neonatal sepsis in very low birth weight (VLBW) infants

DING Yan; SHI Ying-ying; SHEN Yue-hua

Abstract：Objective To explore the perinatal risk factors and clinical features of nosocomial neonatal sepsis in very-low-birth-weight (VLBW)infants. Methods Twenty-nine VLBW infants with nosocomial sepsis and 108 VLBW infants with non-sepsis born in hospital from January 2005 to June 2008 composed the study population. Their maternal,perinatal, or postnatal variables were retrospectively analyzed. SPSS11.0 software was used to do statistical tests and multiple logistic regression. Results Among 137 VLBW infants, twenty-nine were nosocomial neonatal sepsis (21.16% , 29/137). The mortality rate was 13.79% (4/29), The incidence of nosocomial sepsis was increased with the gestational age and birth weight decreased. Gram-negative bacteria accounted for 70% of microbes, Klebsiella pneu-moniae and Escherichia coli were the most common bacterial pathogen causing nosocomial infection, mainly extended spectrum betalactamase producing enterobacteriaceae (ESBLs). Birth weight ≤1000g was the most impotant risk predic-tor of nosocomial neonatal sepsis, incidence of NBSIs was 75% (6/8), OR 7.56 (4.35～14.24). The risk factors were in the order of percutaneously inserted central catheter (PICC) , anaemia, necrotizing enterocolitis (NEC) and apnea.Conclusion Nosocomial neonatal sepsis is a common problem and the main cause of late-onset death among very-low-birth-weight (VLBW) infants. This nosocomial infection should be lowered by active management.