Early-onset sepsis in very preterm neonates in Australia and New Zealand, 2007–2018. Issue 1 (15th June 2022)

• Record Type: Journal Article
• Authors: Duggan, Husharn L; Chow, Sharon S W; Austin, Nicola C; Shah, Prakeshkumar S; Lui, Kei; Tan, Kenneth
• Other Names: author non-byline.; Morris Scott author non-byline.; Schmidt Peter author non-byline.; Korostenski Larissa author non-byline.; Sharp Mary author non-byline.; Gill Andy author non-byline.; Pillow Jane author non-byline.; Stack Jacqueline author non-byline.; Birch Pita author non-byline.; Nothdurft Karen author non-byline.; Casalaz Dan author non-byline.; Holberton Jim author non-byline.; Stewart Alice author non-byline.; Hunt Rod author non-byline.; Cooke Lucy author non-byline.; Downe Lyn author non-byline.; Stewart Michael author non-byline.; Berry Andrew author non-byline.; Hickey Leah author non-byline.; Morris Peter author non-byline.; Paoli Tony De author non-byline.; Spotswood Naomi author non-byline.; Bolisetty Srinivas author non-byline.; Lui Kei author non-byline.; Paradisis Mary author non-byline.; Greenhalgh Mark author non-byline.; Koorts Pieter author non-byline.; Kuschel Carl author non-byline.; Doyle Lex author non-byline.; Craven John author non-byline.; Collins Clare author non-byline.; Numa Andrew author non-byline.; Carlisle Hazel author non-byline.; Badawi Nadia author non-byline.; Popat Himanshu author non-byline.; Koh Guan author non-byline.; Davis Jonathan author non-byline.; Luig Melissa author non-byline.; Headley Bevan author non-byline.; Andersen Chad author non-byline.; Austin Nicola author non-byline.; Darlow Brian author non-byline.; Edmonds Liza author non-byline.; Mildenhall Lindsay author non-byline.; Buksh Mariam author non-byline.; Battin Malcolm author non-byline.; Boom Jutta vanden author non-byline.; Richardson Vaughan author non-byline.; Chambers Georgina author non-byline.; Rajadurai Victor Samuel author non-byline.; Barker David author non-byline.; Dhawan Anjali author non-byline.; Hammond Barbara author non-byline.; Merida Natalie author non-byline.; Ng Linda author non-byline.;
• Is Part Of: Archives of disease in childhood. Volume 108:Issue 1(2023)
• Page Start: 31
• Page End: 37
• Publication Date: 2022-06-15
• Subjects: Neonatology -- Sepsis -- Epidemiology; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2021-323243
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: To evaluate the epidemiology and population trends of early-onset sepsis in very preterm neonates admitted to neonatal intensive care units (NICU) in Australia and New Zealand. Design: Retrospective observational cohort study using a dual-nation registry database. Setting: 29 NICUs that have contributed to the Australian and New Zealand Neonatal Network. Participants: Neonates born at <32 weeks' gestation born between 2007 and 2018 and then admitted to a NICU. Main outcome measures: Microorganism profiles, incidence, mortality and morbidity. Results: Over the 12-year period, 614 early-onset sepsis cases from 43 178 very preterm admissions (14.2/1000 admissions) were identified. The trends of early-onset sepsis incidence remained stable, varying between 9.8 and 19.4/1000 admissions (linear trend, p=0.56). The leading causative organisms were Escherichia coli ( E. coli ) (33.7%) followed by group B Streptococcus ( GBS ) (16.1%). The incidence of E. coli increased between 2007 (3.2/1000 admissions) and 2018 (8.3/1000 admissions; p=0.02). Neonates with E. coli had higher odds of mortality compared with those with GBS (OR=2.8, 95% CI 1.2 to 6.1). Mortality due to GBS decreased over the same period (2007: 0.6/1000 admissions, 2018: 0.0/1000 admissions; p=0.01). Early-onset sepsis tripled the odds of mortality (OR=3.0, 95% CI 2.4 to 3.7) and halved the odds of survival without morbidity (OR=0.5, 95% CI 0.4 to 0.6). Conclusion: Early-onset sepsis remains an important condition among very preterm populations. Furthermore, E. coli is a dominant microorganism of very preterm early-onset sepsis in Australia and New Zealand. Rates of E. coli have been increasing in recent years, while GBS -associated mortality has decreased. Abstract : In a retrospective study from the Australian New Zealand Neonatal Network database, incidence of early onset sepsis in infants less than 32 weeks gestation was stable over 12 years, and incidence of e.coli, the predominant organism, increased.