Background During hospital stay after birth, preterm infants are susceptible to late-onset sepsis (LOS). Objective To study the effect of family integrated care in single family rooms (SFRs) compared to standard care in open bay units (OBUs) on LOS. Peripheral or central venous catheters (PVCs/CVCs) and parenteral nutrition (PN) were investigated as potential mediators. Secondary outcomes were length of stay, exclusive breastfeeding at discharge, and weight gain during hospital stay. Methods Single-center retrospective before-after study with preterm infants admitted ≥3 days. Results We studied 1,046 infants (468 in SFRs, 578 in OBUs, median gestational age 35 weeks). SFRs were associated with less LOS (adjusted odds ratio (OR) 0.486, 95% confidence interval (CI): 0.293; 0.807, p = 0.005). PVCs (indirect effect −1.757, 95% CI: −2.738; −1.068), CVCs (indirect effect −1.002, 95% CI: −2.481; 0.092), and PN (indirect effect −1.784, 95% CI: −2.688; −1.114) were possible mediators of the effect. PN was the main mediator of the effect of SFRs on LOS. We found shorter length of stay (median length of stay in SFRs 10 days and in OBUs 12 days, adjusted β −0.088, 95% CI: −0.159; −0.016, p = 0.016), but no differences in weight gain or exclusive breastfeeding at discharge. Conclusions SFRs were associated with decreased incidences of LOS and shorter length of hospital stay. The positive effect of SFRs on LOS was mainly mediated through a decreased use of PN in SFRs. Impact Family integrated care (FICare) in single family rooms for preterm infants was associated with less late-onset sepsis events during hospital stay and a shorter length of hospital stay after birth. FICare in single family rooms was associated with less use of peripheral or central venous catheters and parenteral nutrition. Mediation analysis provided insights into the mechanisms underlying the effect of FICare in single family rooms on late-onset sepsis and helped explain the differences observed in late-onset sepsis between FICare in single family rooms and open bay units. The reduction in late-onset sepsis in FICare in single family rooms was mediated by a reduced use of intravenous catheters and parenteral nutrition.

中文翻译：

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早产儿和迟发性败血症单户家庭综合护理：回顾性研究和中介分析

背景 在出生后住院期间，早产儿易患迟发性败血症 (LOS)。目的 研究与开放式隔间 (OBU) 中的标准护理相比，单间家庭房 (SFR) 中的家庭综合护理对 LOS 的影响。外周或中心静脉导管 (PVCs/CVCs) 和肠外营养 (PN) 被研究作为潜在的介质。次要结果是住院时间、出院时纯母乳喂养和住院期间体重增加。方法 对住院≥3 天的早产儿进行单中心回顾性前后研究。结果 我们研究了 1,046 名婴儿（SFR 中 468 名，OBU 中 578 名，中位胎龄 35 周）。SFR 与较低的 LOS 相关（调整后的优势比 (OR) 0.486，95% 置信区间 (CI)：0.293；0.807，p = 0.005）。PVC（间接影响 -1.757，95% CI：-2.738；-1.068），CVC（间接影响 -1.002，95% CI：-2.481；0.092）和 PN（间接影响 -1.784，95% CI：-2.688；-1.114）可能是影响的中介因素。PN 是 SFR 对 LOS 影响的主要介质。我们发现住院时间较短（SFR 10 天和 OBU 12 天的中位住院时间，调整后的 β -0.088，95% CI：-0.159；-0.016，p = 0.016），但体重增加或纯母乳喂养没有差异出院时。结论 SFR 与 LOS 发生率降低和住院时间缩短有关。SFR 对 LOS 的积极影响主要是通过减少 SFR 中 PN 的使用来介导的。影响 早产儿单户家庭综合护理 (FICare) 与住院期间迟发性败血症事件较少以及出生后住院时间较短有关。FICare 在单户房中与较少使用外周或中心静脉导管和肠外营养有关。中介分析提供了对单户房中 FICare 对迟发性败血症影响的潜在机制的见解，并帮助解释了单户房中 FICare 和开放式隔间单元之间在迟发性败血症中观察到的差异。FICare 单户房中迟发性败血症的减少是通过减少静脉导管和肠外营养的使用来介导的。中介分析提供了对单户房中 FICare 对迟发性败血症影响的潜在机制的见解，并帮助解释了单户房中 FICare 和开放式隔间单元之间在迟发性败血症中观察到的差异。FICare 单户房中迟发性败血症的减少是通过减少静脉导管和肠外营养的使用来介导的。中介分析提供了对单户房中 FICare 对迟发性败血症影响的潜在机制的见解，并帮助解释了单户房中 FICare 和开放式隔间单元之间在迟发性败血症中观察到的差异。FICare 单户房中迟发性败血症的减少是通过减少静脉导管和肠外营养的使用来介导的。