Risk Factors of Necrotizing Enterocolitis in Neonates With Bloodstream Infections: A Case-Control Study.

This article investigates the risk factors and clinical outcomes of bloodstream infection (BSI) associated with necrotizing enterocolitis (NEC) in neonates through a multi-centered retrospective case-control study conducted in four neonatal intensive care units (NICUs) from 2015 to 2024. The study found that Klebsiella species were the most common pathogens in NEC-associated BSIs, which occurred in about 11.6% of NEC cases and were linked to lower gestational age, lower birth weight (BW), and higher NEC severity (Bell’s stage III). Independent risk factors for NEC-associated BSI included lower BW and elevated initial white blood cell (WBC) count, while BSI, vasopressor use, and respiratory support were independently associated with increased NEC-attributable mortality. The findings suggest that NEC-associated BSI is a significant prognostic factor for worse outcomes, including higher mortality and increased rates of surgical NEC, underscoring the need for vigilant clinical evaluation and management in affected neonates.