Infections following surgical patent ductus arteriosus ligation in very-low-birthweight neonates. 2018

K Kopeć-Godlewska, and J Wójkowska-Mach, and
Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.

BACKGROUND Very-low-birthweight (VLBW) neonates (<1500g) comprise approximately 1% of liveborn infants in Poland. Patent ductus arteriosus (PDA) is a common complication of prematurity. This study aimed to determine how many VLBW neonates treated in the participating units needed surgical correction of PDA, and to evaluate the incidence of various types of postoperative infections and their microbiology. METHODS Observational study in five neonatology departments by the Polish Neonatology Surveillance Network, involving 2039 VLBW newborns of whom 103 (5.1%) required surgical PDA ligation. Continuous infection surveillance was conducted between 2009 and 2013; infections were defined based on Gastmeier's criteria. RESULTS PDA surgery was required significantly more frequently in infants from multiple pregnancies, and where labour was complicated by amnionitis. Surgical PDA correction was performed, on average, at 19 days of life. The incidence of infection was 48.5% (N = 50), and the most common infections were bloodstream infection (26.2%) and pneumonia (22.3%). A correlation was observed between the day on which the procedure was performed and the time of infection: the earlier the neonate underwent PDA surgery, the earlier the infection manifested (P = 0.032). A high CRIB score and chorioamnionitis contributed significantly to the presence of infection. CONCLUSIONS The later the PDA surgery was performed, the later the infection occurred. The incidence of infection after correction of PDA among VLBW neonates was comparable with the incidence of infection among all hospitalized VLBW neonates.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008026 Ligation Application of a ligature to tie a vessel or strangulate a part. Ligature,Ligations,Ligatures
D008297 Male Males
D011014 Pneumonia Infection of the lung often accompanied by inflammation. Experimental Lung Inflammation,Lobar Pneumonia,Lung Inflammation,Pneumonia, Lobar,Pneumonitis,Pulmonary Inflammation,Experimental Lung Inflammations,Inflammation, Experimental Lung,Inflammation, Lung,Inflammation, Pulmonary,Inflammations, Lung,Inflammations, Pulmonary,Lobar Pneumonias,Lung Inflammation, Experimental,Lung Inflammations,Lung Inflammations, Experimental,Pneumonias,Pneumonias, Lobar,Pneumonitides,Pulmonary Inflammations
D011044 Poland A country in central Europe, east of Germany. The capital is Warsaw. Polish People's Republic,Republic of Poland
D004374 Ductus Arteriosus, Patent A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth. Patent Ductus Arteriosus Familial,Patency of the Ductus Arteriosus,Patent Ductus Arteriosus
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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