Early and Late Onset Neonatal Sepsis: Epidemiology and Effectiveness of Empirical Antibacterial Therapy in a III Level Neonatal Intensive Care Unit

Mariani, Marcello; Parodi, Alessandro; Minghetti, Diego; Ramenghi, Luca A.; Palmero, Candida; Ugolotti, Elisabetta; Medici, Chiara; Saffioti, Carolina; Castagnola, Elio

doi:10.3390/antibiotics11020284

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…11 In contrast, in a Korean 35 study assessing medical records over 20 years, the main causative agents of neonatal sepsis were CoNS (53%), S. aureus (12.5%) and K. pneumoniae (7%). Also in the retrospective analysis of 13-year period in north Italy hospitals, leading pathogen of EOS and LOS were CoNS, 36 which is consistent with the findings in this study. It is important to note, in the current study, S. aureus was not isolated from the blood of newborns, and as the latest data collected in Kazakhstan, shows that S. aureus fades into the background.…”

Section: Discussionsupporting

confidence: 91%

Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Kolesnichenko¹,

Kadyrova²,

Lavrinenko³

et al. 2022

IDR

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This study aimed to determine predisposing factors for negative outcome in infants with early neonatal sepsis during COVID-19. Patients and Methods: A prospective cohort study of 172 newborns up to 4 days diagnosed with neonatal sepsis was carried out in Karaganda (Kazakhstan). The microbiological examination was used to identify a causative agent of bloodstream infection. ELISA was performed to determine the total anti-SARS-CoV-2 antibodies. Gestational age, mode of delivery, birth weight, C-reactive protein and procalcitonin levels, comorbidities, type of pathogen, duration of hospitalization and mother's infection diseases were used for statistical analysis. Results: Mortality in infants with neonatal sepsis was 22% (38/172). Anti-SARS-CoV-2 antibodies were detected in 68.3% of the newborns. Culture-negative ELBW infants have a 5.3-fold higher risk of death (p<0.001). Low gestational age and a shorter period of hospitalization were statistically associated with fatality. CRP is generally higher in deceased children (p=0.002). Necrotizing enterocolitis (p<0.001), pneumonia (p=0.009) and anemia (p=0.016) were significantly associated with negative outcome. And, 31.4% of the infants with sepsis had positive blood cultures. The leading cause of sepsis in newborns was CoNS -57%. Conclusion:During COVID-19 pandemic neonatal sepsis mortality was associated with low birth weight, gestational age, and comorbidities as in non-pandemic time. The relationship between COVID-19 in the mother and neonatal mortality was not found. However, anti-SARS-CoV-2 antibodies were detected in more than half of newborns.

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Section: Discussionsupporting

confidence: 91%

Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Kolesnichenko¹,

Kadyrova²,

Lavrinenko³

et al. 2022

IDR

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“…Mariani et al came up with the findings that different pathogens were involved in patients with early and late-onset sepsis, and empirical treatment, which was effective, was also different in both groups of patients. 16 Our results supported their findings as derangement of cerebrospinal fluid markers was seen more in patients with late-onset neonatal sepsis admitted to the neonatal intensive care unit for management. Emphasis should be laid on performing this basic investigation early in neonates with lateonset sepsis, as the chances of meningeal involvement may be higher in this group.…”

Section: Discussionsupporting

confidence: 89%

Comparison of Derangement of Cerebrospinal Fluid Markers in Neonates with Early and Late-Onset Sepsis

Qadir,

Syed Awais Ul Hassan Shah,

Zeeshan Ahmed

et al. 2023

PAFMJ

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Objective: To compare derangement of cerebrospinal fluid markers in neonates with early and late-onset sepsis managed at the Neonatal Intensive Care Unit. Study Design: Comparative cross-sectional study. Setting and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Jun 2022. Methodology: This study was conducted on neonates managed at our Neonatal Intensive Care Unit for late or early-onset sepsis. A consultant neonatologist diagnosed neonatal sepsis based on clinical and laboratory findings. The cerebrospinal fluid routine examination was performed on all the study participants, and the derangement of various markers was compared in neonates with early and late-onset sepsis. Results: A total of 348 neonates admitted to the neonatal intensive care unit with sepsis were included in the final analysis. The mean age of the newborns included in the study was 5.38±4.53 days. Out of all the neonates in the study, 194(55.7%) had early-onset sepsis, while 154(44.3%) neonates had late-onset sepsis. All the cerebrospinal fluid markers were statistically significantly deranged in patients with late-onset sepsis (p-value<0.005). Conclusion: Derangement of cerebrospinal fluid markers was seen more in patients with late-onset neonatal sepsis admitted to the neonatal intensive care unit. Emphasis should be laid on performing this necessary investigation timely in neonates with late-onset sepsis as chances of meningeal involvement are higher in this group.

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“…The number of MDR strains associated with LOS was significantly higher than that of EOS, which is consistent with similar studies. 9 , 29 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

Fang¹,

Gao²,

Yang³

et al. 2023

IDR

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Introduction Sepsis is the most severe infectious disease with the highest mortality rate, particularly among neonates admitted to the neonatal intensive care unit (NICU). This study retrospectively analyzed the epidemiology, antibiotic resistance profiles, and prevalence of multidrug-resistant (MDR) bacteria isolated from blood or cerebrospinal fluid (CSF) cultures in order to evaluate the appropriateness of initial empirical therapy for neonatal sepsis. Methods A retrospective study was conducted in the NICU from January 1, 2015, to December 31, 2022. Microbiological data from patients admitted to the NICU were anonymously extracted from the Laboratory of Microbiology database. Neonatal sepsis was classified into two types: early-onset sepsis (EOS), which occurs within the first 72 hours of life, and late-onset sepsis (LOS) for those begins later. Results A total of 679 bacterial strains, 543 from blood and 136 from CSF, were detected in 631 neonates. Among these, 378 isolates (55.67%) were Gram-positive bacteria, and 301 isolates (44.33%) were Gram-negative bacteria. The most frequently isolated pathogens were Coagulase-negative staphylococci (CoNS) (36.52%), followed by Klebsiella pneumoniae (20.47%) and Escherichia coli (13.84%). In EOS, 121 strains were found, CoNS represented the majority (33.88%), followed by Klebsiella pneumoniae (23.97%) and Escherichia coli (8.26%). Early-onset septicemia exhibited 67 (55.37%) MDR bacteria. In LOS, 558 strains were isolated, CoNS represented the majority of pathogens (37.10%), followed by Klebsiella pneumoniae (19.71%) and Escherichia coli (15.05%). Late-onset septicemia showed 332 (59.50%) MDR bacteria. High rates of MDR were found in CoNS (76.21%), carbapenem-resistant Klebsiella pneumoniae (66.91%), and MRSA (33.33%). Conclusion The study revealed an alarming prevalence of MDR strains isolated from neonatal sepsis, emphasizing the necessity of finding effective prevention and treatment measures. Colistin can be used for MDR Gram-negative bacteria, while vancomycin and teicoplanin can be considered treatment therapies for staphylococcal infections.

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Early and Late Onset Neonatal Sepsis: Epidemiology and Effectiveness of Empirical Antibacterial Therapy in a III Level Neonatal Intensive Care Unit

Cited by 10 publications

References 24 publications

Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Mortality Risk Factors of Early Neonatal Sepsis During COVID-19 Pandemic

Comparison of Derangement of Cerebrospinal Fluid Markers in Neonates with Early and Late-Onset Sepsis

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

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