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50 Late Onset Neonatal Sepsis (LOS) in very low Birth Weight Infants: A Multicentric Study in the Neocosur South American Network

Background LOS is an important cause of mortality and morbidity among very low birth weight (VLBW) infants. Aim To determine the incidence, bacteriology and associated morbidity to LOS over a 10 year period in a South American Network. Methods Data were prospectively collected with predefined diagnostic criteria on all VLBW infants born in 18 centers from this Network, from 2001 through 2010. For numerical variables, mean and standard deviations were calculated. Students-t test or Chi Square tests were used for comparisons as appropriate. Logistic regression was used to assess association between sepsis and morbidity conditions. Results 11651 VLBW were included, with a mean BW 1086±279 g and GA of 29.9±3 weeks. A 19% acquired LOS, with a slight decrease in incidence from 19.5% in the 2001–2005 period to 17.5% in 2010. There was a wide intercenter variability from 5.9% to 29.6 %. The most common pathogens were CONS (53%) and Staphylococcus aureus (11%). Infants who developed LOS were significantly smaller by weight and gestational age. Multivariate logistic regression analysis showed a positive association between LOS and an increased risk for patent ductus arteriosus (OR: 1.510 [95% CI: 1.113–2.049]), NEC (OR: 0.427 [95% CI: 0.373–0.488]) and mechanical ventilation (OR: 0.383 [95% CI: 0.327–0.449]). Conclusions LOS remains an important cause of morbidity among VLBW infants with a wide intercenter variability. Decreasing LOS is a present important challenge for neonatal centers and networks may contribute in this purpose.