Organ Dysfunction Varies Widely in Preterm Late-Onset Bacteremia
This descriptive cohort argues that binary culture-based sepsis labels obscure the physiologic severity data that should guide neonatal antimicrobial and supportive care decisions.
Preterm infants show diverse organ dysfunction patterns during late-onset bacteremia.
Understanding organ dysfunction variability in preterm infants with late-onset bacteremia can enhance neonatal sepsis management beyond binary classifications. In 221 preterm infants, organ dysfunction showed substantial variability, with a median maximum Neonatal Sequential Organ Failure Assessment (nSOFA) score of 6 (IQR, 1-9) for Gram-negative and 3 (IQR, 0-9) for Gram-positive bacteremia. This study highlights the limitations of relying solely on binary microbiologic criteria, suggesting a need for more nuanced frameworks to assess neonatal sepsis outcomes effectively. Neonatal sepsis management benefits from understanding the heterogeneity in organ dysfunction beyond binary pathogen classifications.
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Authors:Liu S, Missigman E, Al Gharaibeh FN, Park WY, Lawler B, Kuiper JR, Makker K, Moreira AG, Wynn JL, Aziz KB
Citation:Liu S, Missigman E, Al Gharaibeh FN, et al. Heterogeneity of Critical Organ Dysfunction During Late-Onset Bacteremia in Preterm Infants. JAMA network open. 2026;9(9):e2632792. doi:10.1001/jamanetworkopen.2026.32792