Early-onset neonatal sepsis in the Paris area: a population-based surveillance study from 2019 to 2021

Sikias, P.; Biran, Valérie; Foix‐L’Hélias, L.; Plainvert, Céline; Boileau, Pascal; Bonacorsi, Stéphane

doi:10.1136/archdischild-2022-324080

Cited by 11 publications

(16 citation statements)

References 19 publications

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“…After implementing intrapartum antibiotic prophylaxis, the incidence and mortality of EOS have decreased significantly in the past decades, especially in developed countries [ 1 , 2 ]. The incidence of EOS was 0.32–0.97 per 1000 live births in Europe, comparable to reports from the USA (1.08/1000) and Australia (0.67/1000) [ 1 , 2 , 3 , 4 , 5 ]. However, its incidence remains higher in developing countries, where data is scarce [ 6 , 7 ].…”

Section: Introductionsupporting

confidence: 79%

Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

et al. 2022

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Background: The pathogen distribution and antibiotic susceptibility of the pathogens in early-onset sepsis (EOS) differ between countries. The epidemiological data from a limited number of studies about EOS in Turkey are insufficient. In this study, we aimed to evaluate the culture-proven EOS cases, causative microorganisms, antibiotic susceptibility patterns, and risk factors for mortality in EOS. Methods: This is a retrospective, single-center study over a 7-year period, from 2013 to 2020, at Zeynep Kamil Maternity and Children’s Hospital, İstanbul, Turkey. Results: During the study period, 8229 newborns were admitted to our neonatal intensive care unit. Culture-proven EOS was detected in 101 patients (0.12%). Out of these, 56 (55.4%) were Gram-positive, and 45 (44.5%) were Gram-negative sepsis. The most common isolated organism was E. coli (28.7%, n = 29), followed by GBS (16.8%, n = 17) and S. aureus (15.8%, n = 16). An ampicillin and gentamicin combination had antimicrobial coverage in 92.6% of cases. Seventeen patients (16.8%) died because of EOS. Severe neutropenia was found to be an independent risk factor for mortality in EOS (p = 0.001, OR = 14.4, CI 95%: 2.8–74). Conclusions: Although the majority of causative agents were Gram-positive (55.4%), the most common isolated organism was E. coli. An empirical antibiotic regimen of ampicillin and gentamicin continues to have an adequate coverage for EOS in our population.

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Section: Introductionsupporting

confidence: 79%

Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

et al. 2022

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“…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). 3,[6][7][8][11][12][13][14] E. coli is also one of the most common pathogenic bacteria causing neonatal bacterial meningitis.…”

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%

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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“…This finding is in agreement with recent observations showing an increase in E. coli infections among very low birth weight infants and among late preterm infants. [27][28][29] Such an observation is important since this bacterium is part of the endogenous gut flora, raising awareness of the need for improved local hygiene to prevent such ascending infection, especially when pPROM is suspected or confirmed.…”

Section: Watterberg Et Al First Reported An Association Between Chorio-mentioning

confidence: 99%

Effect of acute histologic chorioamnionitis on bronchopulmonary dysplasia and mortality rate among extremely low gestational age neonates: A retrospective case–control study

Costa,

Fattore,

De Santis

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo evaluate whether acute histologic chorioamnionitis (HCA) diagnosed in the placenta may be associated with an increased occurrence of bronchopulmonary dysplasia (BPD) or death among extremely low gestational age neonates (ELGAN).MethodsThis Italian single‐center case–control retrospective study involved ELGAN admitted to the neonatal intensive care unit between January 2019 and June 2022. Infants born from pregnant women with acute and severe HCA, identified as stage ≥2 and grade 2 HCA, (HCA‐infants) were compared with infants of pregnant women without chorioamnionitis or with stage 1, grade 1 chorioamnionitis (no‐HCA‐infants).ResultsAmong 101 eligible ELGAN, 63 infants had complete clinical and histologic data relevant to the study: thirty infants were included in the HCA‐infants group and 33 in the no‐HCA‐infants group. Neonatal and maternal demographic and clinical characteristics were similar between the two groups. Infants born from mothers with acute and severe HCA had significantly higher occurrence of composite BPD or death (18 [60%] vs. 9 [27%]; P = 0.012), as well as higher incidence of severe forms of BPD (6 [30%] vs. 2 [6%]; P = 0.045). In multiple logistic regression analysis, after adjustment for confounding covariates, HCA was an independent risk factor for BPD or death (OR, 4.49; 95% CI: 1.47–13.71).ConclusionsThis is the first study showing that in utero exposure to acute and severe HCA is an independent risk factor for the occurrence of composite BPD or death among ELGAN.

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Early-onset neonatal sepsis in the Paris area: a population-based surveillance study from 2019 to 2021

Cited by 11 publications

References 19 publications

Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

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

Effect of acute histologic chorioamnionitis on bronchopulmonary dysplasia and mortality rate among extremely low gestational age neonates: A retrospective case–control study

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