Relationship Between COVID-19 Lockdown and Epidemiology of Neonatal Sepsis. Issue 6 (6th May 2022)

• Record Type: Journal Article
• Authors: Dutta, Sourabh; Kumar, Praveen; Paulpandian, Rajarajan; Sajan Saini, Shiv; Sreenivasan, Priya; Mukhopadhyay, Kanya; Sundaram, Venkataseshan; Kumar, Jogender; Ray, Pallab
• Is Part Of: Pediatric infectious disease journal. Volume 41:Issue 6(2022)
• Page Start: 482
• Page End: 489
• Publication Date: 2022-05-06
• Subjects: SARS-CoV-2 -- Acinetobacter baumannii -- septicemia -- multi-drug resistant -- newborn; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003489
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: We compared the hospital-based epidemiology of neonatal sepsis after the coronavirus disease 2019 lockdown (LD) versus historical epochs and the LD period versus phases of unlocking. Methods: This retrospective cohort study was conducted in a level 3 neonatal unit. We compared neonates born in three 24-week periods—Group LD : 22 March 2020 to 5 September 2020—the reference group, Group pre-LD : 29 September 2019 to 14 March 2020 and Group temporally corresponding to LD in 2019 ( corres-LD ): 24 March 2019 to 7 September 2019. We also studied linear trends from LD phase 1.0 until Unlock 4.0. The key outcome was culture-positive sepsis. Results: There were 1622, 2744 and 2700 subjects in groups LD, pre-LD and corres-LD, respectively. The incidence of any culture-positive sepsis in pre-LD was higher than LD [odds ratio (95% CI) = 1.61 (1.02–2.56)]. This was mainly due to a statistically significant reduction in Acinetobacter baumannii sepsis, with incidence rate differences of pre-LD versus LD [0.67 (95% CI: 0.37–0.97), P = 0.0001] and corres-LD versus LD [0.40 (95% CI: 0.16–0.64), P = 0.0024]. Groups pre-LD and corres-LD had higher proportion of multi-drug resistant (MDR)/extreme drug resistance/pan drug resistance sepsis than LD [77%, 77% and 44%, respectively ( P values of both groups vs. LD = 0.01)]. From LD 1.0 to unlock 4.0, there were fewer episodes of MDR sepsis ( P linear trends = 0.047). On multivariable analysis, group pre-LD (vs. reference group LD ), male sex, birth weight and Apgar score independently predicted culture-positive sepsis. Conclusions: LD favorably impacted the epidemiology of neonatal sepsis in a hospital setting, with less A. baumannii and MDR sepsis, which persisted during unlocking.