Neonatal bacteraemia in Ireland: A ten-year single-institution retrospective review

Abstract

Neonatal sepsis is a catastrophic condition of global concern, with reported mortality rates exceeding 10%. Bloodstream infections are an important cause of sepsis, and epidemiological studies of these infections are crucial for predicting the most common aetiological agents and antimicrobial susceptibility patterns and for developing antimicrobial guidelines. For the ten-year study period from July 2013 to June 2023, all neonatal bacteraemia cases were reviewed prospectively using an enhanced surveillance protocol. The patients were stratified according to their age at the time of blood culture collection: early onset if diagnosed in the first 72 hours of life, and late onset if diagnosed after that time. During the study period, 170 blood cultures were positive from 144 patients, of which 89 specimens from 64 patients represented the growth of significant pathogens. Coagulase-negative staphylococci (CoNS) were the most common pathogens identified (52%, 33/64), followed by Escherichia coli (14%, 9/64), Group B Streptococcus (GBS: 11%, 7/64) and Staphylococcus aureus (11%, 7/64). GBS was more commonly identified in early onset patients, while CoNS were predominantly associated with late onset. The presence of an intravascular catheter, maternal urinary tract infections and the receipt of total parenteral nutrition or transfused blood were identified as significant risk factors. The fatality rate was 8% (5/64). in summary, this study provides a detailed overview of the epidemiology of neonatal bacteraemia in a large teaching hospital in the Midwest of Ireland over a decade.

Fig 1. Number of cases of neonatal bacteraemia per year, early onset neonatal sepsis (EONS, < 72 hours of age), late onset neonatal sepsis (LONS, > 72 hours of age) and “not significant” (positive blood cultures yielding growth not considered significant, i.e., contaminants).

Fig 2. Source of infection: Patients > 72 hours of age (LONS).

Fig 3. Intravascular catheter-associated infections per year Central venous catheter (CVC), peripheral venous cannula (PVC) and peripherally inserted central catheter (PICC).