Mortality following blood culture in premature infants: Increased with Gram-negative bacteremia and candidemia but not Gram-positive bacteremia

Abstract

Objective: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. Study Design: Multicenter cohort study of premature infants. Results: First blood culture was negative for 4648/5497 (78%) of the neonates - 390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR) = 2.61] and candidemia (HR = 2.27) were associated with increased mortality; CONS (HR = 1.08) and GP-o (HR = 0.97) were not.7 Conclusions: Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Grum-positive bacteremia was not. © 2004 Nature Publishing Group All rights reserved.