Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months

Timo R de Haan, Loes Beckers, Rogier C J de Jonge, Lodewijk Spanjaard, Letty van Toledo, Dasja Pajkrt, Aleid G van Wassenaer-Leemhuis, Johanna H van der Lee

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis.

METHODS: Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997-2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley-test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis.

RESULTS: Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2% and 2.2%, respectively. During the follow-up period the mortality rate was 34% for both GNS and NCS and 5% for UC. The adjusted Odds Ratio (OR) [95% CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4-4.9]. The adjusted ORs [95% CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5-15.9] and 3.2 [0.7-14.7], respectively.

CONCLUSIONS: We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram-negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period.

Original languageEnglish
Pages (from-to)e59214
JournalPLoS ONE
Volume8
Issue number3
DOIs
Publication statusPublished - 2013

Cite this

de Haan, T. R., Beckers, L., de Jonge, R. C. J., Spanjaard, L., van Toledo, L., Pajkrt, D., ... van der Lee, J. H. (2013). Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months. PLoS ONE, 8(3), e59214. https://doi.org/10.1371/journal.pone.0059214
de Haan, Timo R ; Beckers, Loes ; de Jonge, Rogier C J ; Spanjaard, Lodewijk ; van Toledo, Letty ; Pajkrt, Dasja ; van Wassenaer-Leemhuis, Aleid G ; van der Lee, Johanna H. / Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months. In: PLoS ONE. 2013 ; Vol. 8, No. 3. pp. e59214.
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title = "Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months",
abstract = "OBJECTIVES: To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis.METHODS: Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997-2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley-test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis.RESULTS: Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2{\%} and 2.2{\%}, respectively. During the follow-up period the mortality rate was 34{\%} for both GNS and NCS and 5{\%} for UC. The adjusted Odds Ratio (OR) [95{\%} CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4-4.9]. The adjusted ORs [95{\%} CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5-15.9] and 3.2 [0.7-14.7], respectively.CONCLUSIONS: We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram-negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period.",
keywords = "Candidiasis/complications, Cerebral Palsy/epidemiology, Child Development/physiology, Cohort Studies, Cross Infection/complications, Gram-Negative Bacteria, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases/epidemiology, Netherlands/epidemiology, Odds Ratio, Sepsis/complications, Statistics, Nonparametric",
author = "{de Haan}, {Timo R} and Loes Beckers and {de Jonge}, {Rogier C J} and Lodewijk Spanjaard and {van Toledo}, Letty and Dasja Pajkrt and {van Wassenaer-Leemhuis}, {Aleid G} and {van der Lee}, {Johanna H}",
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de Haan, TR, Beckers, L, de Jonge, RCJ, Spanjaard, L, van Toledo, L, Pajkrt, D, van Wassenaer-Leemhuis, AG & van der Lee, JH 2013, 'Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months' PLoS ONE, vol. 8, no. 3, pp. e59214. https://doi.org/10.1371/journal.pone.0059214

Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months. / de Haan, Timo R; Beckers, Loes; de Jonge, Rogier C J; Spanjaard, Lodewijk; van Toledo, Letty; Pajkrt, Dasja; van Wassenaer-Leemhuis, Aleid G; van der Lee, Johanna H.

In: PLoS ONE, Vol. 8, No. 3, 2013, p. e59214.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Neonatal gram negative and Candida sepsis survival and neurodevelopmental outcome at the corrected age of 24 months

AU - de Haan, Timo R

AU - Beckers, Loes

AU - de Jonge, Rogier C J

AU - Spanjaard, Lodewijk

AU - van Toledo, Letty

AU - Pajkrt, Dasja

AU - van Wassenaer-Leemhuis, Aleid G

AU - van der Lee, Johanna H

PY - 2013

Y1 - 2013

N2 - OBJECTIVES: To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis.METHODS: Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997-2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley-test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis.RESULTS: Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2% and 2.2%, respectively. During the follow-up period the mortality rate was 34% for both GNS and NCS and 5% for UC. The adjusted Odds Ratio (OR) [95% CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4-4.9]. The adjusted ORs [95% CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5-15.9] and 3.2 [0.7-14.7], respectively.CONCLUSIONS: We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram-negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period.

AB - OBJECTIVES: To evaluate the long term neurodevelopmental outcome of premature infants exposed to either gram- negative sepsis (GNS) or neonatal Candida sepsis (NCS), and to compare their outcome with premature infants without sepsis.METHODS: Historical cohort study in a population of infants born at <30 weeks gestation and admitted to the Neonatal Intensive Care Unit (NICU) of the Academic Medical Center in Amsterdam during the period 1997-2007. Outcome of infants exposed to GNS or NCS and 120 randomly chosen uncomplicated controls (UC) from the same NICU were compared. Clinical data during hospitalization and neurodevelopmental outcome data (clinical neurological status; Bayley-test results and vision/hearing test results) at the corrected age of 24 months were collected. An association model with sepsis as the central determinant of either good or adverse outcome (death or severe developmental delay) was made, corrected for confounders using multiple logistic regression analysis.RESULTS: Of 1362 patients, 55 suffered from GNS and 29 suffered from NCS; cumulative incidence 4.2% and 2.2%, respectively. During the follow-up period the mortality rate was 34% for both GNS and NCS and 5% for UC. The adjusted Odds Ratio (OR) [95% CI] for adverse outcome in the GNS group compared to the NCS group was 1.4 [0.4-4.9]. The adjusted ORs [95% CI] for adverse outcome in the GNS and NCS groups compared to the UC group were 4.8 [1.5-15.9] and 3.2 [0.7-14.7], respectively.CONCLUSIONS: We found no statistically significant difference in outcome at the corrected age of 24 months between neonatal GNS and NCS cases. Suffering from either gram-negative or Candida sepsis increased the odds for adverse outcome compared with an uncomplicated neonatal period.

KW - Candidiasis/complications

KW - Cerebral Palsy/epidemiology

KW - Child Development/physiology

KW - Cohort Studies

KW - Cross Infection/complications

KW - Gram-Negative Bacteria

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Infant, Premature

KW - Infant, Premature, Diseases/epidemiology

KW - Netherlands/epidemiology

KW - Odds Ratio

KW - Sepsis/complications

KW - Statistics, Nonparametric

U2 - 10.1371/journal.pone.0059214

DO - 10.1371/journal.pone.0059214

M3 - Article

VL - 8

SP - e59214

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 3

ER -