Immunomodulation, Part II: Granulocyte Colony-Stimulating Factors

IN A RECENT STUDY OF LATE-ONSET SEPSIS in very low birth weight (VLBW) neonates, the National Institute of Child Health and Human Development Neonatal Research Network found that, of 6,215 infants who survived beyond three days, 1,313 (21 percent) had experienced at least one episode of blood culture–proven sepsis. Not only does sepsis increase the length of stay in the NICU, but VLBW neonates with sepsis are significantly more likely to die than uninfected infants (18 percent vs 7 percent).¹ The most recently published statistics on sepsis-related neonatal mortality reveal that early neonatal mortality from sepsis declined from an average of 24.9/100,000 live births between 1985 and 1991 to an average of 15.6/100,000 live births between 1995 and 1998. During the same time period, the rate of late neonatal mortality from sepsis increased from 14.8/100,000 live births between 1985 and 1991 to 16.2/100,000 live births between 1995 and 1998.² The immaturity of bactericidal mechanisms, including the production and function of neutrophils, is one factor in this high rate of sepsis and related mortality.³