Epidemiology and Mortality of Early-Onset Neonatal Sepsis in Suriname: A 2-Year Surveillance Study

Abstract We conducted a nationwide surveillance study to produce reliable national estimates on incidence, etiology, and mortality of early-onset neonatal sepsis (EONS) in Suriname. The estimated national population incidence rate of EONS was 1.37 (95% CI: 0.90–1.99) per 1000 live births and in-hospital mortality was 25.9%.

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Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

SciMedicine Journal ◽

10.28991/scimedj-2021-0303-7 ◽

2021 ◽

Vol 3 (3) ◽

pp. 257-264

Author(s):

Sandeep Golhar ◽

Abhishek Madhura ◽

Urmila Chauhan ◽

Abinash Nayak

Keyword(s):

Blood Culture ◽

Hospital Mortality ◽

Positive Blood Culture ◽

Neonatal Sepsis ◽

Early Onset ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

Term Neonates ◽

Diagnosis And Prognosis

Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p<0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

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Characteristics of neonatal herpes simplex virus infections in Germany: results of a 2-year prospective nationwide surveillance study

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2021-321940 ◽

2021 ◽

pp. fetalneonatal-2021-321940

Author(s):

André Kidszun ◽

Anna Bruns ◽

Daniel Schreiner ◽

Susanne Tippmann ◽

Julia Winter ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Surveillance Study ◽

Patient Treatment ◽

Neonatal Herpes ◽

Live Births ◽

Nationwide Surveillance ◽

Neonatal Herpes Simplex ◽

Simplex Virus ◽

Hsv Infections

ObjectiveTo assess incidence and burden of neonatal herpes simplex virus (HSV) infections and to explore possible transmission routes.MethodsA 2-year prospective nationwide surveillance study performed in 2017 and 2018. All German paediatric departments (n=464 in 2017, n=441 in 2018) were contacted on a monthly basis to report potential cases of neonatal HSV infections. Infants with a postnatal age of ≤60 days and a positive HSV PCR or HSV culture from skin, mucous membrane, vesicles or conjunctival smear, blood or cerebrospinal fluid were included in the study.Results37 cases were analysed. 29 patients who exhibited no or only mild clinical symptoms were discharged home without organ damage or neurological abnormalities. Four patients showed significant neurological impairment, one patient required liver transplantation and two patients died during in-patient treatment. The 2-year incidence of neonatal HSV infections was 2.35 per 100 000 live births (95% CI 1.69 to 3.02) and disease-specific mortality was 0.13 per 100 000 live births (95% CI 0.04 to 0.21). Data on possible transmission routes were available in 23 cases. In 20 cases, an orofacial HSV infection was present in one or more family members. An active maternal genital HSV infection was reported in 3 cases.ConclusionNeonatal HSV infections are rare in Germany. Most infants have a benign clinical course, but some infants are severely affected. Postnatal HSV exposure may account for a considerable number of neonatal HSV infections.

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Early-onset neonatal infections in Australia and New Zealand, 2002–2012

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314671 ◽

2018 ◽

Vol 104 (3) ◽

pp. F248-F252 ◽

Cited By ~ 14

Author(s):

Tarun Singh ◽

Elizabeth H Barnes ◽

David Isaacs

Keyword(s):

New Zealand ◽

Incidence Rate ◽

Early Onset ◽

Group B Streptococcus ◽

E Coli ◽

Live Births ◽

Early Onset Sepsis ◽

Group B ◽

Almost All ◽

Over Time

BackgroundThe epidemiology of early-onset neonatal sepsis (EONS) varies over time, and requires regular surveillance.ObjectiveTo analyse data on EONS in Australia and New Zealand.MethodsRetrospective analysis of data collected longitudinally from multiple neonatal units from 2002 to 2012.ResultsOf 386 423 live births, 454 infants had EONS. The incidence rate of EONS was 1.20 per 1000 live births in 2002 and 0.83 in 2012, decreasing by 4% per year (95% CI 1% to 7%, p=0.007). Group B streptococcus (GBS) (37%) and Escherichia coli (25%) were the most prevalent organisms. The early-onset GBS (EOGBS) incidence rate was 0.43/1000 live births, with no evidence of change over time (p=0.3). Of EOGBS-infected babies, 62% were born at term compared with 8% with early-onset E. coli sepsis, p<0.0001. The mortality of E. coli early-onset sepsis (EOS) (25%) was higher than GBS (11%), but this difference in mortality was no longer significant after adjusting for gestation and birth weight. Mortality from EOS fell significantly over the study period (17% per year, 95% CI 10 to 24, p<0.0001).ConclusionsGBS was the most common cause of early sepsis, but the incidence was lower than prior to the introduction of intrapartum antibiotic prophylaxis, and remained steady over time. The mortality of early-onset E. coli sepsis was significantly higher than GBS sepsis, but this may have been because almost all babies with E. coli were born preterm, rather than a difference in virulence.

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Procalcitonin and Neonatal Sepsis: Is This the Biomarker We Are Looking For?

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.36.6.380 ◽

2017 ◽

Vol 36 (6) ◽

pp. 380-384 ◽

Cited By ~ 3

Author(s):

Susan Givens Bell

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

Diagnostic Marker ◽

C Reactive Protein ◽

Neonatal Deaths ◽

Live Births ◽

Neonatal Disease ◽

Protein Levels ◽

Reactive Protein ◽

Early Onset Sepsis

AbstractResearchers estimate the incidence of early onset sepsis as 0.77–1/1,000 live births. It remains as one of the leading causes of neonatal deaths. Clinicians and researchers continue to search for biomarkers for specific neonatal disease processes. Clinicians frequently trend C-reactive protein levels during evaluation for neonatal sepsis. Recently, researchers have begun to explore procalcitonin as a potentially useful diagnostic marker for neonatal sepsis.

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Implementation of an adapted Sepsis Risk Calculator algorithm to reduce antibiotic usage in the management of early onset neonatal sepsis: a multicentre initiative in Wales, UK

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-321489 ◽

2021 ◽

pp. fetalneonatal-2020-321489

Author(s):

Nitin Goel ◽

Stephanie Cannell ◽

Gemma Davies ◽

Murali Sridhar Natti ◽

Vickness Kirupaalar ◽

...

Keyword(s):

Outcome Measures ◽

Neonatal Sepsis ◽

Early Onset ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Consensus Guideline ◽

Risk Calculator ◽

Live Births ◽

Sepsis Risk ◽

The Impact

ObjectiveAssess the impact of introducing a consensus guideline incorporating an adapted Sepsis Risk Calculator (SRC) algorithm, in the management of early onset neonatal sepsis (EONS), on antibiotic usage and patient safety.DesignMulticentre prospective studySettingTen perinatal hospitals in Wales, UK.PatientsAll live births ≥34 weeks’ gestation over a 12-month period (April 2019–March 2020) compared with infants in the preceding 15-month period (January 2018–March 2019) as a baseline.MethodsThe consensus guideline was introduced in clinical practice on 1 April 2019. It incorporated a modified SRC algorithm, enhanced in-hospital surveillance, ongoing quality assurance, standardised staff training and parent education. The main outcome measure was antibiotic usage/1000 live births, balancing this with analysis of harm from delayed diagnosis and treatment, disease severity and readmissions from true sepsis. Outcome measures were analysed using statistical process control charts.Main outcome measuresProportion of antibiotic use in infants ≥34 weeks’ gestation.Results4304 (14.3%) of the 30 105 live-born infants received antibiotics in the baseline period compared with 1917 (7.7%) of 24 749 infants in the intervention period (45.5% mean reduction). All 19 infants with culture-positive sepsis in the postimplementation phase were identified and treated appropriately. There were no increases in sepsis-related neonatal unit admissions, disease morbidity and late readmissions.ConclusionsThis multicentre study provides evidence that a judicious adaptation of the SRC incorporating enhanced surveillance can be safely introduced in the National Health Service and is effective in reducing antibiotic use for EONS without increasing morbidity and mortality.

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Early-onset and late-onset group B streptococcal disease in Japan: a nationwide surveillance study, 2004–2010

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2012.11.027 ◽

2013 ◽

Vol 17 (6) ◽

pp. e379-e384 ◽

Cited By ~ 21

Author(s):

Kousaku Matsubara ◽

Kiyoshi Hoshina ◽

Yoko Suzuki

Keyword(s):

Early Onset ◽

Late Onset ◽

Surveillance Study ◽

Streptococcal Disease ◽

Nationwide Surveillance ◽

Group B Streptococcal Disease ◽

Group B ◽

Onset Group

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Incidence and factors associated with mortality of neonatal sepsis

Paediatrica Indonesiana ◽

10.14238/pi51.3.2011.144-8 ◽

2011 ◽

Vol 51 (3) ◽

pp. 144 ◽

Cited By ~ 3

Author(s):

I Made Kardana

Keyword(s):

Birth Weight ◽

Mortality Rate ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Early Onset ◽

Mode Of Delivery ◽

Developed Countries ◽

Live Births ◽

Factors Associated ◽

Early Onset Sepsis

Background Neonatal sepsis is one of the major causes of mortality and long term morbidity in neonates, particularly in premature and low birth weight infants. The incidence of neonatal sepsis varies from 1 to 4 in 1000 live births in developed countries and 10 to 50 in 1000 live births in developing countries. The mortality rate of neonatal sepsis remains high, especially in developing countries.Objective To describe the incidence, mortality rate, and factors associated 'With mortality in neonatal sepsis in Sanglah Hospital, Denpasar.Methods A retrospective, cohort study was conducted in the Perinatology Ward, Department of Child Health, Sanglah Hospital, Denpasar, Bali from January to December 2008. One hundred thirty􀁄eight patients 'With neonatal sepsis were enrolled in this study. Patients' characteristic data were collected including sex, mode of delivery (spontaneous, non􀁄spontaneous), condition at birth (vigorous, asphyxic), gestational age (premature, full tenn), birth weight «2500 grams, > 2500 grams), and sepsis classifica􀁄tion (early onset sepsis, late onset sepsis). Outcomes were grouped into alive and dead.Results A total of 138 cases of neonatal sepsis were reviewed, 59.4% of whom were boys, 63.0% spontaneously delivered,39.1 % asphyxic, 53.6% 'With low birth weight, 50.7% premature, and84.8% with early onset sepsis. The incidence of neonatal sepsis was 5% of babies admitted, 'With a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated withmortality in neonatal sepsis (RR8.4, 95% CI 2.4 to 29.0, P = 0.001 and RR3.4, 95% ClI.O to 11.0, P 􀀂 0.042, respectively). Conclusion The incidence of neonatal sepsis in Sanglah Hospital was 5% of babies admitted, with a mortality rate of 28.3%. Low birth weight and prematurity were significantly associated with mortality in neonatal sepsis. 2011;51:144-8].

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NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.1215 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pramod P. Singhavi

Keyword(s):

Risk Factors ◽

Neonatal Sepsis ◽

Early Onset ◽

Late Onset ◽

Signs And Symptoms ◽

Premature Rupture ◽

Maternal Risk ◽

Late Onset Sepsis ◽

Early Onset Sepsis ◽

Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

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