Risk Factors for Late Onset Gram-Negative Sepsis in Low Birth Weight Infants Hospitalized in the Neonatal Intensive Care Unit

BACKGROUND:Gram-negative bloodstream infections (BSIs) cause 20–30% of late onset sepsis in neonatal intensive care unit (NICU) patients and have mortality rates of 30–50%. We investigated risk factors for late onset Gram-negative sepsis in very low birth weight (10 days; nasal cannula continuous positive airway pressure use; H2 blocker/proton pump inhibitor use; and gastrointestinal tract pathology. CONCLUSIONS:These analyses provide insights into potential strategies to reduce Gram-negative BSIs. Catheters should be removed as possible and H2 blockers/proton pump inhibitors should be used judiciously in NICU patients. The association between nasal cannula continuous positive airway pressure and Gram-negative BSIs requires further investigation. The association of gastrointestinal tract pathology with Gram-negative BSIs identifies a high risk group of neonates who may benefit from enhanced preventative strategies.