Aim: Late-onset sepsis (LOS) is common in extreme prematurity. These infants are at risk of refeeding syndrome-associated hypophosphataemia. Our objective was to investigate whether hypophosphataemia predisposes to LOS in extremely premature neonates.
Methods: A retrospective case-control study of neonates born before 29 weeks' gestation in an Australian NICU from 2016 to 2020. Cases developed LOS or localised infection. Two controls, matched within 2 gestational weeks and 90 calendar days, were selected per case.
Results: Amongst 48 cases and 93 controls, cases were smaller at birth (767 g vs. 901 g, P = 0.01), but were otherwise comparable. Hypophosphataemia was more common in cases (26% vs. 15%, P = 0.18). Increased intravenous protein intake in the first week was protective against LOS (OR = 0.9, 95% CI 0.76-1.00, P = 0.04); median 2.1 g/kg/day in cases, 2.3 g/kg/day in controls.
Conclusions: Hypophosphataemia as part of refeeding syndrome is prevalent and under-recognised in extremely premature neonates. We did not find an association between hypophosphataemia and LOS. Low intravenous protein may be an independent risk factor for infection.
Background: Physiological-based cord clamping (PBCC) in preterm infants is beneficial for cardiovascular transition at birth and may optimize placental transfusion. Whether PBCC can improve clinical outcomes is unknown. The aim of the Aeration, Breathing, Clamping (ABC3) trial was to test whether PBCC results in improved intact survival in very preterm infants.
Late-onset sepsis (LOS) is commonly associated with pathogens acquired in hospital or community settings and carries a significant risk of morbidity and mortality in neonates. We present a case of a late preterm neonate, born at 36 weeks and 2 days with low birth weight (1700 g), who was admitted to the neonatal intensive care unit (NICU) and developed LOS on the fourth day of life. LOS was diagnosed in the context of fever and lethargy, mild thrombocytopenia, leukopenia, and lymphopenia, and was caused by multidrug-resistant (MDR) , confirmed through blood culture.
() is a coagulase-negative staphylococci. This group of bacteria is typically part of the skin flora but can become pathogenic in susceptible hosts, such as preterm infants with prolonged stays in neonatal intensive care units. Two preterm newborns with late-onset sepsis caused by , one of whom also developed meningitis.
The study investigates how different reasons for revision surgery in adult spinal deformity (ASD) patients affect their postoperative outcomes, revealing a high incidence of reoperations.
A sample of 891 ASD patients was analyzed retrospectively, categorizing their revisions by cause, and assessing complications, radiographic results, and disability metrics.
Findings suggest that different etiologies (mechanical, infection, wound, and SI pain) lead to varying outcomes, with mechanical issues showing less improvement over time compared to others.
Importance: Previous research has examined outcomes among very preterm newborns by the birthing parent's race and ethnicity, but knowledge about these trends during the COVID-19 pandemic is limited.
Objective: To examine trends in outcomes among Black, Hispanic, and Asian preterm newborns compared with White preterm newborns.
Design, Setting, And Participants: This cohort study (2018-2022) took place at 774 neonatal intensive care units in the Vermont Oxford Network.
