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


CONCLUSION
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.
['Kopeć-Godlewska|K|K|', 'Wójkowska-Mach|J|J|', '|||']
D004374:Ductus Arteriosus, Patent D005260:Female D006801:Humans D015994:Incidence D007223:Infant D007231:Infant, Newborn D019102:Infant, Very Low Birth Weight D008026:Ligation D008297:Male D011014:Pneumonia D011044:Poland D012189:Retrospective Studies D012307:Risk Factors D018805:Sepsis D013530:Surgical Wound Infection
Infections Patent ductus arteriosus Polish neonatology surveillance network Very low birthweight