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. 2024;121(6):703-714.
doi: 10.1159/000539174. Epub 2024 Jun 18.

Epidemiology and Outcomes of Neonatal Sepsis: Experience from a Tertiary Australian NICU

Cheryl Anne Mackay  1   2 , Elizabeth A Nathan  2 , Michelle Claire Porter  3 , Damber Shrestha  1 , Rolland Kohan  1   2 , Tobias Strunk  1   2   4
Affiliations

Epidemiology and Outcomes of Neonatal Sepsis: Experience from a Tertiary Australian NICU

Cheryl Anne Mackay et al. Neonatology. 2024.

Abstract

Introduction: Neonatal sepsis is associated with significant mortality and morbidity. Low-middle-income countries are disproportionately affected, but late-onset sepsis (LOS) still occurs in up to 20% of infants <28 weeks in high-income countries. Understanding site-specific data is vital to guide management.

Methods: A retrospective cohort study was conducted at King Edward Memorial Hospital (KEMH), Perth. Infants admitted between January 2012 and June 2022 were included. Data were extracted from routine electronic databases. Incidence and aetiology of sepsis were determined and the association of sepsis with neonatal outcomes analysed.

Results: During the study period, 23,395 newborns were admitted with a median gestation of 37 weeks and birth weight of 2,800 g. There were 370 sepsis episodes in 350 infants; 102 were early-onset sepsis (EOS) (1.6 per 1,000 live births), predominantly Streptococcus agalactiae (35, 34.3%) and Escherichia coli (27, 26.5%); 268 were LOS (0.9 per 1,000 inpatient days), predominantly coagulase-negative staphylococci (CONS) (156, 57.6%) and E. coli (30, 11.1%). The incidence of LOS declined from 2012 to 2022 (p = 0.002). Infants with EOS had increased brain injury (25.7% vs. 4.1%; p = 0.002) and mortality (18.8% vs. 1.6%; p < 0.001). Those with LOS had increased hospital stay (median 95 vs. 15 days; p < 0.001), mortality (15.3% vs. 1.6%; p = 0.018), necrotising enterocolitis (NEC) (7.4% vs. 0.5%; p < 0.001), and chronic lung disease (CLD) (58.1% vs. 5.9%; p = 0.005). Infants <28 weeks with sepsis were at increased risk of neurodevelopmental impairment compared to those without infection (43.2% vs. 30.9%, p = 0.027).

Conclusions: While we observed a reduction in LOS incidence, sepsis remains associated with higher mortality, and in survivors with longer hospital stay and increased risk of brain injury, NEC, CLD, and neurodevelopmental impairment.

Keywords: Early-onset sepsis; Late-onset sepsis; Neonate; Outcomes.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Liveborn infants born from 2012 to 2022 with and without sepsis.
Fig. 2.
Fig. 2.
Blood culture isolates for early- and late-onset neonatal sepsis.
Fig. 3.
Fig. 3.
Incidence of EOS and LOS by gestational age and year.
See this image and copyright information in PMC

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References

    1. Rosa-Mangeret F, Benski AC, Golaz A, Zala PZ, Kyokan M, Wagner N, et al. . 2.5 million annual deaths-are neonates in low- and middle-income countries too small to be seen? A bottom-up overview on neonatal morbi-mortality. Trop Med Infect Dis. 2022;7(5):64. - PMC - PubMed
    1. Giannoni E, Agyeman PKA, Stocker M, Posfay-Barbe KM, Heininger U, Spycher BD, et al. . Neonatal sepsis of early onset, and hospital-acquired and community-acquired late onset: a prospective population-based cohort study. J Pediatr. 2018;201:106–14.e4. - PubMed
    1. Li J, Shen L, Qian K. Global, regional, and national incidence and mortality of neonatal sepsis and other neonatal infections, 1990-2019. Front Public Health. 2023;11:1139832. - PMC - PubMed
    1. Mashau RC, Meiring ST, Dramowski A, Magobo RE, Quan VC, Perovic O, et al. . Culture-confirmed neonatal bloodstream infections and meningitis in South Africa, 2014-19: a cross-sectional study. Lancet Glob Health. 2022;10(8):e1170–8. - PMC - PubMed
    1. Chow SSW, Holberton JR, Chambers GM, Lui K. Report of the Australian and New Zealand Neonatal Network 2021. ANZNN: Sydney: Australian and New Zealand Neonatal Network 2021; 2023.

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