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279 THE EPIDEMIOLOGY OF EARLY-ONSET VERSUS LATE-ONSET BLOODSTREAM INFECTIONS IN A NEONATAL INTENSIVE CARE UNIT.
  1. R. Saisan1,
  2. B. Afghani1,
  3. E. Afghani1,
  4. J. Sills1
  1. 1University of California, Irvine Medical Center, Irvine, CA.

Abstract

Bloodstream infections in neonates continue to be a significant ailment despite improvements in health care practice, most likely due to multiple risk factors affecting both early-onset and late-onset sepsis.

Objective To compare the epidemiologic characteristics of early-onset and late-onset bloodstream infections in neonates treated at the University of California, Irvine neonatal intensive care unit (UCI-NICU) over a 7-year period.

Methods All neonates with positive blood cultures treated at UCI-NICU between January 1998 and December 2004 were identified and their medical records were reviewed. Early-onset bacteremia was defined as an episode of bacteremia within the first 7 days of life.

Results We identified 56 episodes of early onset and 160 episodes of late-onset bloodstream infections (see Table).

Gram-negative bacteria caused bloodstream infections more frequently in early onset compared with late onset, whereas coagulase-negative Staphylococcus (CONS) was more common in late-onset infections. Comparing risk factors for patients with early-onset and late-onset bloodstream infections, as expected, those with early-onset infections were less likely to have had surgeries (5.4% vs 38%), prior antibiotic therapy (37.5% vs 90%), shorter duration of intubation (2 days vs 13.7 days), and shorter duration of central lines (3.7 days vs 28.7 days).

Conclusions The predominant bacterial causes of early-onset and late-onset bloodstream infections are different. Elucidation of epidemiologic trends and risk factors associated with early- and late-onset bloodstream infections will have significant implications in developing measures to control the occurrence of these infections.

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