Polymicrobial bloodstream infections in the neonatal intensive care unit are associated with increased mortality: A case-control study

Mohan Pammi, Danni Zhong, Yvette Johnson, Paula Revell, James Versalovic

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

Background: Polymicrobial infections in adults and children are associated with increase in mortality, duration of intensive care and healthcare costs. Very few studies have characterized polymicrobial bloodstream infections in the neonatal unit. Considerable variation has been reported in incidence of polymicrobial infections and associated clinical outcomes. We characterized the risk factors and outcomes of polymicrobial bloodstream infections in our neonatal units in a tertiary hospital in North America.Methods: In a retrospective case control study design, we identified infants in the neonatal intensive care unit with positive blood cultures at Texas Children's Hospital, over a 16-year period from January 1, 1997 to December 31, 2012. Clinical data from online databases were available from January 2009 to December 2012. For each polymicrobial bloodstream infection (case), we matched three infants with monomicrobial bloodstream infection (control) by gestational age and birth weight.Results: We identified 2007 episodes of bloodstream infections during the 16 year study period and 280 (14%) of these were polymicrobial. Coagulase-negative Staphylococcus, Enterococcus, Klebsiella and Candida were the most common microbial genera isolated from polymicrobial infections. Polymicrobial bloodstream infections were associated with more than 3-fold increase in mortality and an increase in duration of infection. Surgical intervention was a significant risk factor for polymicrobial infection.Conclusion: The frequency and increased mortality emphasizes the clinical significance of polymicrobial bloodstream infections in the neonatal intensive care unit. Clinical awareness and focused research on neonatal polymicrobial infections is urgently needed.

Original languageEnglish (US)
Article number390
JournalBMC Infectious Diseases
Volume14
Issue number1
DOIs
StatePublished - Jul 14 2014

Keywords

  • Infant
  • Mortality
  • Neonate
  • NICU
  • Polymicrobial
  • Sepsis

ASJC Scopus subject areas

  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Polymicrobial bloodstream infections in the neonatal intensive care unit are associated with increased mortality: A case-control study'. Together they form a unique fingerprint.

Cite this