Epidemiological evolution of early-onset neonatal sepsis over 12 years: A single center, population-based study in central Taiwan

Lu, I-Chun; Chen, Y; Chiu, Hsiao-Yu; Tsai, Ming-Hsien; Cheng, H; Chang, Yun Sil; Lin, Hung‐Chih

doi:10.3233/npm-210938

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…1,2 To reduce neonatal mortality and long term adverse consequences caused by bacterial infection, it is vital to select appropriate empirical antibiotics when a neonatal infection is suspected. In most developing countries, including China, Escherichia coli (E. coli) is usually the leading pathogen in neonatal sepsis, [2][3][4][5][6][7] especially in premature infants. 1,[8][9][10] E. coli plays an important role in causing both early-onset sepsis (EOS) and late-onset sepsis (LOS).…”

Section: Introductionmentioning

confidence: 99%

“…1,[8][9][10] E. coli plays an important role in causing both early-onset sepsis (EOS) and late-onset sepsis (LOS). 3,[6][7][8][11][12][13][14] E. coli is also one of the most common pathogenic bacteria causing neonatal bacterial meningitis. [15][16][17] Neonate with E. coli meningitis can have adverse nervous system sequelae, which is an important cause of poor long-term prognosis of newborns with E. coli sepsis.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Zhu¹,

Wang²,

Zhuge³

et al. 2023

IDR

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Background and Objective: An increasing number of cases of neonatal sepsis due to extended-spectrum beta-lactamase (ESBL)producing multi-drug resistant (MDR) Escherichia coli (E. coli) have been reported worldwide. The aim of this study was to explore the risk factors associated with ESBL-producing MDR E. coli among neonates with culture-confirmed E. coli sepsis and thereby to help selection of appropriate empirical antibiotics. Patients and Methods: All newborn infants with a confirmed pathogen isolated from blood or cerebrospinal fluid (CSF) from 2016 to 2021 were identified and those with E. coli infection were included in this analysis. We compared a group of neonatal patients with ESBL-producing MDR E. coli sepsis (n=69) to a group with ESBL-negative E. coli (n=70) based on antimicrobial susceptibility reports. We used multivariable regression analysis to determine the risk factors associated with ESBL-producing MDR E. coli strains among the neonates with culture-confirmed E. coli sepsis. Results: ESBL-producing MDR E. coli sepsis was more common in premature infants and newborns with hospital-acquired late-onset sepsis (HALOS). The mortality rate of neonatal sepsis caused by ESBL-producing E. coli was about twice as that of sepsis caused by ESBL-negative E. coli. Antepartum exposure to cephalosporins (OR=25.191, P<0.01) and parenteral nutrition for more than 1 week (OR=4.495, 95% CI: 2.009-10.055, P<0.01) were independent risk factors for neonatal infection with ESBL-producing stains among infants with E. coli sepsis. Conclusion: E. coli remains the most common Gram-negative bacterial pathogen causing neonatal sepsis. A higher proportion of ESBLproducing MDR E. coli is seen in premature infants and those newborns with HALOS and is associated with higher mortality. Antepartum use of cephalosporins and prolonged use of parenteral nutrition may be important factors to consider in the selection of empirical antibiotics for use in neonatal sepsis caused by gram-negative rods prior to the availability of the results of antimicrobial susceptibility.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Zhu¹,

Wang²,

Zhuge³

et al. 2023

IDR

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Intrapartum antibiotic prophylaxis to prevent Group B streptococcal infections in newborn infants: a systematic review and meta-analysis comparing various strategies

Panneflek,

Hasperhoven,

Chimwaza

et al. 2024

eClinicalMedicine

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Intrapartum antibiotic prophylaxis to prevent Group B streptococcal infections in newborn infants: a systematic review and meta-analysis comparing various strategies

Panneflek,

Hasperhoven,

Chimwaza

et al. 2024

Preprint

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SummaryBackgroundEarly-onset Group B Streptococcus (EOGBS) leads to substantial morbidity and mortality in newborn infants. Intrapartum antibiotic prophylaxis (IAP) prevents EOGBS infection, but IAP strategies vary. The approach to the provision of IAP can be risk-based, universal or a combination of the two strategies. Previous systematic reviews reported that universal strategies might be most optimal in lowering EOGBS infection, but there is no consensus. Therefore, we aimed to provide up-to-date evidence on effectiveness of different strategies by comparing perinatal outcomes.MethodsA systematic search for EOGBS prevention strategies was performed in MEDLINE, Embase and Web of Science. Studies were included if they reported on different strategies and outcomes of interest, including EOGBS infection, IAP administration and antimicrobial resistance. Summary data was extracted from published reports. Study quality was assessed using the ROBINS-I tool. Random-effects meta-analyses were used to determine risk ratios (RR) and 95%-confidence intervals. PROSPERO registration CRD42023411806.FindingsA total of 6050 records were identified, of which 72 observational studies were included for synthesis with more than 10 million live births. Meta-analysis demonstrated that implementation of any strategy (n=34 studies, RR 0.46 (0.36-0.60)), risk-based strategies (n=11 studies, RR 0.65 (0.48-0.87)), or universal strategies (n=16 studies, RR 0.37 (0.25-0.55)) was associated with a reduced risk of EOGBS infection compared to no strategy. In direct comparison, universal strategies were associated with a reduced risk of EOGBS compared to a risk-based strategy (n=17 studies, RR 0.41 (0.30-0.55)), while the proportion of women receiving IAP did not differ between risk-based (16%) and universal (21%) strategies (n=9 studies, RR 1.29 (0.95-1.75)). There was no antimicrobial resistance of EOGBS isolates to penicillin or ampicillin (n=11 studies).InterpretationAny IAP strategy could reduce the risk of EOGBS infection without evidence of increasing antimicrobial resistance. Universal strategies give the largest reduction in the EOGBS burden, while not exposing a significantly higher proportion of pregnancies to IAP compared to risk-based strategies.FundingUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, a cosponsored programme executed by the World Health Organisation.

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Epidemiological evolution of early-onset neonatal sepsis over 12 years: A single center, population-based study in central Taiwan

Cited by 3 publications

References 20 publications

Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Intrapartum antibiotic prophylaxis to prevent Group B streptococcal infections in newborn infants: a systematic review and meta-analysis comparing various strategies

Intrapartum antibiotic prophylaxis to prevent Group B streptococcal infections in newborn infants: a systematic review and meta-analysis comparing various strategies

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