Latest news with #VLBW
Medscape
02-07-2025
- Health
- Medscape
Glucose Monitoring Shows Dysglycaemia in Premature Infants
TOPLINE: In very low birth weight (VLBW) infants, continuous glucose monitoring (CGM) at 36 weeks of postmenstrual age (PMA) revealed subclinical dysglycaemia; male infants showed prolonged hyperglycaemia, and prior insulin therapy predicted extended hypoglycaemia. METHODOLOGY: Researchers evaluated the prevalence of dysglycaemia in VLBW infants at 36 weeks of PMA through CGM and investigated associated risk factors. The prospective cohort included 35 VLBW infants (mean gestational age, 27.3 weeks; 65.7% female infants; mean birth weight, 929 g) who were assessed at 36 weeks from 2016 to 2019. CGM was performed at 36 weeks of PMA using a blinded Dexcom G4 sensor for 48 hours, with dysglycaemia defined as glucose concentrations > 8 mmol/L (hyperglycaemia) or < 2.6 mmol/L (hypoglycaemia) sustained for at least 30 minutes. Researchers analysed risk factors (sex and prior insulin therapy) against capillary glucose correlations. TAKEAWAY: Overall, dysglycaemia was detected in 68.6% of infants; 28.6% of infants had hyperglycaemia alone, 17.1% had hypoglycaemia alone, and 22.9% had both. Male sex was linked to a longer duration of hyperglycaemia (B = 252.172; CI, 101.484-402.86; P = .002). Prior insulin treatment led to an increase in the duration of hypoglycaemia (B = 68.607; CI, 9.932-127.283; P = .023). Lower birth size and bronchopulmonary dysplasia were also associated with dysglycaemia. IN PRACTICE: "Male sex is associated with longer time spent in hyperglycemia and insulin treatment during the admission period is associated with longer time spent in hypoglycemia nearing term age. It is possible that these infants may require more rigorous monitoring of their glucose concentrations even when nearing term age," the authors wrote. SOURCE: This study was led by Itay Nilsson Zamir, Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. It was published online on June 27, 2025, in the European Journal of Pediatrics. LIMITATIONS: The single-centre study design and small sample size may have limited generalisability. The CGM device used (Dexcom G4) had a higher-than-ideal mean absolute relative difference (18.8%). Calibrations relied on point-of-care glucometers rather than on laboratory-analysed values. DISCLOSURES: This study was supported by research grants from Umeå University and other sources. The CGM system was donated by Dexcom Inc., which had no role in the study design, data analysis, or publication. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
20-05-2025
- Health
- Medscape
VLBW Hospitalized Infants Face High S aureus Infection Risk
Late-onset invasive Staphylococcus aureus infections affected a substantial proportion of infants hospitalized in neonatal intensive care units (NICUs), with infants with very low birth weight (VLBW; < 1500 g) experiencing a much higher incidence than those with a birth weight ≥ 1500 g. VLBW babies accounted for more than three fourths of infections and the majority of attributable deaths. METHODOLOGY: Researchers conducted a retrospective cohort study to determine the incidence of invasive S aureus infections among 468,201 infants (55.6% boys; median gestational age, 36 weeks) admitted to NICUs across the United States between 2016 and 2021. infections among 468,201 infants (55.6% boys; median gestational age, 36 weeks) admitted to NICUs across the United States between 2016 and 2021. The primary outcome was late-onset invasive S aureus infection, defined as a positive culture result for S aureus from an abscess, blood, cerebrospinal fluid, peritoneum, or pleural fluid, collected at least 4 days after birth. infection, defined as a positive culture result for from an abscess, blood, cerebrospinal fluid, peritoneum, or pleural fluid, collected at least 4 days after birth. Mortality attributed to S aureus infection was defined as the absolute difference in deaths occurring within 7 days of an invasive S aureus infection and deaths among matched infants without an S aureus infection. TAKEAWAY: Among infants with invasive infections, 80.9% were born at 32 weeks of gestation or earlier, 76.5% had VLBW, and 87.5% required central line placement during their NICU stay. Infants with VLBW experienced nearly a 20-fold higher incidence of S aureus infection rates than infants with a birth weight ≥ 1500 g (227.1; 95% CI, 215.3-239.4 vs 10.1; 95% CI, 9.1-11.1 per 10,000 infants). infection rates than infants with a birth weight ≥ 1500 g (227.1; 95% CI, 215.3-239.4 vs 10.1; 95% CI, 9.1-11.1 per 10,000 infants). Among infants with S aureus infections, all-cause mortality was substantially higher in infected infants (12.1% vs 1.0%), with VLBW infants accounting for 90.4% of deaths. infections, all-cause mortality was substantially higher in infected infants (12.1% vs 1.0%), with VLBW infants accounting for 90.4% of deaths. The absolute difference in 7-day all-cause mortality between infants with S aureus infection occurring between postnatal days 4 and 28 and matched infants without infection was 5.3% (95% CI, 3.8-6.8). IN PRACTICE: 'Late-onset invasive S aureus is an important contributor to disease burden in hospitalized infants, especially among infants with VLBW,' the study authors wrote. 'The lack of change in the incidence mediated by enhanced infection prevention measures suggests the need for novel strategies to further reduce the incidence and burden of S aureus infections,' wrote the study authors of the related editorial. SOURCE: The study was led by Aaron M. Milstone, MD, MHS, Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore. It was published online on April 14, 2025, in JAMA Pediatrics . LIMITATIONS: The convenience sample may not have been representative of all hospitalized infants in US NICUs. Data were limited to infants during their admission to participating sites, potentially missing infections that occurred before admission or after transfer to another hospital. Additionally, the researchers were unable to explore differences in outcomes between methicillin-resistant and methicillin-sensitive S aureus infections. DISCLOSURES: The study received support from the Centers for Disease Control and Prevention and the National Institutes of Health. Three authors reported receiving consulting fees, grants, or honoraria from companies such as Tellus Therapeutics, Oak Hill Bio, Pediatrix, AbbVie, and Thermo Fisher Scientific PPD.
