Acute kidney injury in late-onset neonatal bacteraemia: The role of the neonatal sequential organ failure assessment tool in predicting kidney injury.

INTRODUCTION: Neonatal sepsis remains a leading cause of morbidity and mortality across all healthcare systems. Acute kidney injury (AKI) is common in neonates and is associated with poor clinical outcomes. We sought to profile the incidence of AKI in infants with culture-positive bacteraemia and to assess the utility of the neonatal sequential organ failure (nSOFA) tool in AKI prediction.

METHODS: A single-centre retrospective review of infants with culture-positive bacteraemia was performed at the Rotunda Hospital, Dublin, Ireland. Clinical, demographic and biochemical data were collated, with the modified neonatal Kidney Disease: Improving Global Outcomes (KDIGO) criteria and nSOFA scoring applied to each included patient.

RESULTS: Our cohort of n=35 patients with culture-positive bacteraemia had an AKI incidence of 48.6%. There was no statistically significant association between peak nSOFA and the development of AKI.

CONCLUSION: The incidence of AKI in late-onset neonatal clinically significant bacteraemia is high. nSOFA within 24 hours of culture has poor utility in predicting acute kidney injury in neonatal patients with culture-positive bacteraemia.