Objective To evaluate trends in organisms causing early-onset neonatal sepsis (EONS). Congruent with recent reports, we hypothesized there would be an increase in EONS caused by Escherichia coli. Study Design National data on infants admitted to neonatal intensive care units from 2009 to 2014 were compared to previously reported data from 2003 to 2008. We report 430 cases of EONS from 2009 to 2014. Bivariate analyses were used to analyze the distribution of causative organisms over time and differences by gestational age. Linear regression was used to estimate trends in causative organisms. Results Since 2003, there has been a trend of increasing numbers of cases caused by E coli (P<0.01). The predominant organism was E coli in preterm infants and Group B Streptococcus in term infants. Conclusions With the majority of EONS cases now caused by E coli, our findings emphasize the importance of continued surveillance of causative organism patterns and developing approaches to reduce cases caused by E coli.
Transitioning from pediatric to adult care is a complicated process for youth with chronic illnesses. This study elucidates the unique factors affecting transition preparedness and perception of adult HIV care among a cohort of young women with HIV. Between 2013 and 2015, 48 women with HIV, who had experience with pediatric HIV care, were enrolled in a large Canadian cohort study. Variables were self-reported during peer-administered surveys. Only 60% reported feeling prepared for transition. Having never had contact with child protection services ( P = .049), never been in foster care ( P = .011), never been in a group home ( P = .036), reporting a higher current CD4 count ( P = .033), and reporting a younger ideal age for transition ( P = .041) were associated with transition preparedness. Eighty-four percent reported equivalent or better HIV care following transition. Correlates of equivalent/better care following transition included lower personal income ( P = .023), higher CD4 count ( P = .021), care by an adult infectious diseases specialist ( P = .002), and transition preparedness ( P = .005). Our findings highlight the importance of adequate transition preparation and its effect on perception of care following transition.
BACKGROUND: Early-onset neonatal sepsis (EONS) is largely caused by vertical transmission of infectious organisms. The predominant pathogens causing EONS appear to be changing over time, however current prevention efforts focus on group B Streptococcus (GBS). Current and accurate characterization of the organism distribution in EONS is imperative to ensure effective antibiotic prophylaxis during labour and appropriate empiric treatment in neonates with suspected EONS. OBJECTIVES: The objective of this study was to evaluate trends in causative organisms of EONS. Congruent with recent reports, we hypothesized there would be an increase in EONS caused by Escherichia Coli. DESIGN/METHODS: Data was collected for infants admitted to neonatal intensive care units (NICU) participating in the Canadian Neonatal Network (CNN) from 2009 to 2014 with a positive blood or cerebrospinal fluid culture (CSF) within 72 hours of birth. Collected data was compared to previously published data on a cohort from 2003-2008 with the same case definition. The distribution of causative organisms over time was analyzed, as well as differences in causative organisms by gestational age grouping.
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