Clinical Characteristics and Current Treatment Modality of Preterm Infants with spp. Infection.

Background: The impact of and countermeasures for spp. in neonates remain controversial. The aim of this study was to evaluate the associated perinatal factors that can predict the likelihood of respiratory tract spp. colonization and analyze the subsequent clinical course of affected infants, thereby providing the rationale for their diagnosis, treatment, and future study.

Methods: This was a retrospective observational study of infants born at a gestational age (GA) of less than 32 weeks.

Results: The prevalence of respiratory tract spp. colonization was 25.8% (75/291), and it increased with a decrease in GA and birth weight (BW). Maternal vaginal spp. colonization increased the risk of neonatal spp. colonization, with an OR of 7.8 (95% CI: 3.1, 20.0). Infants with spp. colonization had a higher white blood cell (WBC) count, normal C-reactive protein (CRP) level, and higher failure rate of weaning from mechanical ventilation (30.7% vs. 17.1%, = 0.014); they also suffered more from interstitial pneumonia (20.0% vs. 5.6%, < 0.001) and bronchopulmonary dysplasia (36.0% vs. 13.4%, < 0.001). Infants receiving anti- spp. treatment had a lower GA, lower BW, and more severe respiratory syndromes. However, the difference in respiratory manifestation became insignificant after adjusting for GA.

Conclusions: GA and maternal vaginal spp. colonization could be used to predict neonatal respiratory tract spp. colonization. An elevated WBC count combined with normal CRP is a good marker of spp. colonization/infection. It is conventional practice to start anti- spp. treatment when infants present with a deteriorated respiratory condition. This practice warrants further investigation considering GA as a predominant intermediate variable.