{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:49:15Z","timestamp":1791308955733,"version":"4.3.1"},"reference-count":9,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective.<\/jats:title>\n                  <jats:p>To determine the pathogens associated with fulminant (lethal within 48 hours) late-onset sepsis (occurring after 3 days of age) in a neonatal intensive care unit (NICU) and the frequency of fulminant late-onset sepsis for the most common pathogens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>A retrospective study was conducted of sepsis in infants in a NICU over a 10-year period (1988\u20131997).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>There were 825 episodes of late-onset sepsis occurring in 536 infants. Thirty-four of 49 (69%; 95% confidence interval [CI]: 55%\u201382%) cases of fulminant late-onset sepsis were caused by Gram-negative organisms, including Pseudomonassp., 20 (42%); Escherichia coli, 5 (10%);Enterobacter sp., 4 (8%); and Klebsiellasp., 4 (8%). The frequency of fulminant sepsis was highest forPseudomonas sp., 20 of 36 (56%; 95% CI: 38%\u201372%) and lowest for coagulase-negative staphylococci, 4 of 277 (1%; 95%CI: 0%\u20134%). The very low frequency of fulminant sepsis caused by coagulase-negative staphylococci did not increase during the period when oxacillin was used instead of vancomycin as the empiric antibiotic for Gram-positive organisms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>These data suggest that empiric antibiotics selected for treatment of suspected sepsis in infants &amp;gt;3 days old need to effectively treat Gram-negative pathogens, particularlyPseudomonas sp., because these organisms, although less frequent, are strongly associated with fulminant late-onset sepsis in the NICU. Avoiding empiric vancomycin therapy seemed to be a reasonable approach to late-onset sepsis, because of the very low frequency of fulminant sepsis caused by coagulase-negative staphylococci.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.106.6.1387","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"1387-1390","source":"Crossref","is-referenced-by-count":169,"title":["Fulminant Late-Onset Sepsis in a Neonatal Intensive Care Unit, 1988\u20131997, and the Impact of Avoiding Empiric Vancomycin Therapy"],"prefix":"10.1542","volume":"106","author":[{"given":"M. Gary","family":"Karlowicz","sequence":"first","affiliation":[{"name":"1 From the Department of Pediatrics, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Stephen","family":"Buescher","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aqil E.","family":"Surka","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,12,1]]},"reference":[{"key":"2021121003294198700_B1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0022-3476(96)70191-9","article-title":"Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network.","volume":"129","author":"Stoll","year":"1996","journal-title":"J Pediatr."},{"key":"2021121003294198700_B2","first-page":"22758","article-title":"Preventing the spread of vancomycin resistance\u2014a report from the Hospital Infection Control Practices Advisory Committee prepared by the Subcommittee on Prevention and Control of Antimicrobial-Resistant Microorganisms in Hospitals.","volume":"59","author":"Centers for Disease Control and Prevention","year":"1994","journal-title":"Federal Register."},{"key":"2021121003294198700_B3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/00006454-199505000-00006","article-title":"Pseudomonas aeruginosa infection in very low birth weight infants: a case-control study.","volume":"14","author":"Leigh","year":"1995","journal-title":"Pediatr Infect Dis J."},{"key":"2021121003294198700_B4","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1097\/00006454-199907000-00005","article-title":"Increasing incidence of Gram-negative rod bacteremia in a newborn intensive care unit.","volume":"18","author":"Shah","year":"1999","journal-title":"Pediatr Infect Dis J."},{"key":"2021121003294198700_B5","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/00006454-199705000-00006","article-title":"Epidemiology of vancomycin usage at a children's hospital, 1993 through 1995.","volume":"16","author":"Sinkowitz","year":"1997","journal-title":"Pediatr Infect Dis J."},{"key":"2021121003294198700_B6","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1093\/clinids\/20.5.1126","article-title":"Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection.","volume":"20","author":"Edmond","year":"1995","journal-title":"Clin Infect Dis."},{"key":"2021121003294198700_B7","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1093\/clinids\/20.5.1134","article-title":"Editorial response: what can we do about vancomycin-resistant enterococci?","volume":"20","author":"Murray","year":"1995","journal-title":"Clin Infect Dis."},{"key":"2021121003294198700_B8","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2307\/30140952","article-title":"Recommendations for preventing the spread of vancomycin resistance.","volume":"16","author":"Hospital Infection Control Advisory Committee","year":"1995","journal-title":"Infect Control Hosp Epidemiol."},{"key":"2021121003294198700_B9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/BF02767766","article-title":"Positive blood cultures for coagulase-negative staphylococci in neonates: does highly selective vancomycin usage affect outcome?","volume":"26","author":"Matrai-Kovalskis","year":"1998","journal-title":"Infection."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/1387\/892712\/1387.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/1387\/892712\/1387.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T10:16:30Z","timestamp":1639131390000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/106\/6\/1387\/63162\/Fulminant-Late-Onset-Sepsis-in-a-Neonatal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":9,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2000,12,1]]},"published-print":{"date-parts":[[2000,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.106.6.1387","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,12,1]]}}}