Infants with congenital diaphragmatic hernia (CDH) are at high risk of infection, which was predicted by clinical factors, according to a recent study. Therefore, early identification and low threshold for sepsis evaluations in high-risk infants may attenuate acquisition and the consequences of these infections. Researchers conducted a retrospective analysis using the Children's Hospital Neonatal Database during 2010-2016. Infants with CDH admitted at 22 participating regional neonatal intensive care units were included; patients repaired or discharged to home prior to admission/referral were excluded. The primary outcome was death or the occurrence of bloodstream infection or urinary tract infection (UTI) prior to discharge. They found:

• Median gestation and postnatal age at referral in this cohort (n=1,085) were 38 weeks and 3.1 hours, respectively.
• The primary outcome occurred in 395 patients (36%); and was associated with low birth weight, low Apgar, low admission pH, renal and associated anomalies, patch repair, and extracorporeal membrane oxygenation.
• After omitting death from the outcome measure, admission pH, patch repair of CDH, and duration of central line placement were significantly associated with incident bloodstream infection or UTI.