{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:10:00Z","timestamp":1793257800054,"version":"4.5.0"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,8,1]]},"abstract":"<jats:p>Objective. Late-onset sepsis (occurring after 3 days of age) is an important problem in very low birth weight (VLBW) infants. To determine the current incidence of late-onset sepsis, risk factors for disease, and the impact of late-onset sepsis on subsequent hospital course, we evaluated a cohort of 6956 VLBW (401\u20131500 g) neonates admitted to the clinical centers of the National Institute of Child Health and Human Development Neonatal Research Network over a 2-year period (1998\u20132000).<\/jats:p><jats:p>Methods. The National Institute of Child Health and Human Development Neonatal Research Network maintains a prospective registry of all VLBW neonates admitted to participating centers within 14 days of birth. Expanded infection surveillance was added in 1998.<\/jats:p><jats:p>Results. Of 6215 infants who survived beyond 3 days, 1313 (21%) had 1 or more episodes of blood culture-proven late-onset sepsis. The vast majority of infections (70%) were caused by Gram-positive organisms, with coagulase-negative staphylococci accounting for 48% of infections. Rate of infection was inversely related to birth weight and gestational age. Complications of prematurity associated with an increased rate of late-onset sepsis included patent ductus arteriosus, prolonged ventilation, prolonged intravascular access, bronchopulmonary dysplasia, and necrotizing enterocolitis. Infants who developed late-onset sepsis had a significantly prolonged hospital stay (mean length of stay: 79 vs 60 days). They were significantly more likely to die than those who were uninfected (18% vs 7%), especially if they were infected with Gram-negative organisms (36%) or fungi (32%).<\/jats:p><jats:p>Conclusions. Late-onset sepsis remains an important risk factor for death among VLBW preterm infants and for prolonged hospital stay among VLBW survivors. Strategies to reduce late-onset sepsis and its medical, social, and economic toll need to be addressed urgently.<\/jats:p>","DOI":"10.1542\/peds.110.2.285","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:17:55Z","timestamp":1092442675000},"page":"285-291","source":"Crossref","is-referenced-by-count":1857,"title":["Late-Onset Sepsis in Very Low Birth Weight Neonates: The Experience of the NICHD Neonatal Research Network"],"prefix":"10.1542","volume":"110","author":[{"given":"Barbara J.","family":"Stoll","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nellie","family":"Hansen","sequence":"additional","affiliation":[{"name":"Research Triangle Institute, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avroy A.","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda L.","family":"Wright","sequence":"additional","affiliation":[{"name":"National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldemar A.","family":"Carlo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alabama, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Ehrenkranz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Lemons","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann R.","family":"Stark","sequence":"additional","affiliation":[{"name":"Joint Program in Neonatology, Harvard University, Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon E.","family":"Tyson","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence Based Medicine, University of Texas Health Science Center at Houston Medical School, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Oh.","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon B.","family":"Korones","sequence":"additional","affiliation":[{"name":"The Newborn Center, University of Tennessee-Memphis, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Perinatal Medicine, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu-Ann","family":"Papile","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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