Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study
Abstract
:1. Introduction
2. Results
2.1. Overall Initiation and Continuation of Antibiotic Therapy, and Proven EOS Incidence
2.2. Variation among Hospitals
- Regional Hospitals (Hospitals A–M):
- Academic Hospitals (Hospital N and O):
2.3. Academic vs. Regional Hospitals
2.4. Differences within a Three-Year Period
3. Discussion
3.1. Strengths/Limitations
3.2. Clinical Implications
4. Methods
4.1. Study Design, Population and Period
4.2. Data Collection
4.3. Study Outcomes and Definitions
4.4. Statistical Analysis
4.5. Ethical Considerations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Hospitals N = 15 n (%, 95% CI) | Academic Hospitals (Level IV Facilities) N = 2 n (%, 95% CI) | Regional Hospitals (Level I–II Facilities) N = 13 n (%, 95% CI) | Academic vs. Regional | |
---|---|---|---|---|
Relative Risk (95% CI) e | ||||
Number of births | 103492 | 10912 | 92580 | NA |
Culture-proven EOS a | 117 (0.11%, 0.09–0.14) | 30 (0.27%, 0.19–0.39) | 87 (0.09%, 0.08–0.12) | 2.93 (1.93–4.42) |
Antibiotic therapy initiation b | 4755 (4.6%, 4.5–4.7) | 1240 (11.4%, 10.8–12.0) | 3515 (3.8%, 3.7–3.9) | 2.99 (2.81–3.18) |
Antibiotic therapy continuation >48 h/total number of neonates initiated | 2399 (50.5%, 49.0–51.9) | 323 (26.0%, 23.6–28.6) | 2076 (59.1%, 57.4–60.7) | 0.44 (0.40–0.48) |
Antibiotic therapy continuation >48 h/total number of births | 2399 (2.3%, 2.2–2.4) | 323 (3.0%, 2.7–3.3) | 2076 (2.2%, 2.2–2.3) | 1.32 (1.18–1.48) |
Number initiated per culture-proven sepsis case c | 40.6 | 41.3 | 40.4 | 1.00 (0.99–1.01) |
Number continued per culture-proven sepsis case d | 20.5 | 10.8 | 23.9 | 0.94 (0.91–0.98) |
Pathogen Determination | All Positive Blood Cultures | Academic Hospitals | Regional Hospitals |
---|---|---|---|
N = 117 | N = 30 | N = 87 | |
Streptococcus agalactiae | 47 (40.1%) | 9 (30.0%) | 38 (43.7%) |
Escherichia coli | 25 (23.3%) | 7 (23.3%) | 18 (20.7%) |
Staphylococcus aureus | 13 (11.1%) | 5 (16.7%) | 8 (9.2%) |
Streptococcus mitis | 5 (4.3%) | 0 (0.0%) | 5 (5.7%) |
Streptococcus anginosus | 4 (3.4%) | 2 (6.7%) | 2 (2.3%) |
Enterococcus faecalis | 4 (3.4%) | 1 (3.3%) | 3 (3.4%) |
Staphylococcus epidermidis * | 3 (2.6%) | 1 (3.3%) | 2 (2.3%) |
Listeria monocytogenes | 3 (2.6%) | 3 (10.0%) | 0 (0.0%) |
Other pathogens ** | 13 (11.1%) | 3 (10.0%) | 10 (11.5%) |
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van Veen, L.E.J.; van der Weijden, B.M.; Achten, N.B.; van der Lee, L.; Hol, J.; van Rossem, M.C.; Rijpert, M.; Oorthuys, A.O.J.; van Beek, R.H.T.; Dubbink-Verheij, G.H.; et al. Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study. Antibiotics 2024, 13, 537. https://doi.org/10.3390/antibiotics13060537
van Veen LEJ, van der Weijden BM, Achten NB, van der Lee L, Hol J, van Rossem MC, Rijpert M, Oorthuys AOJ, van Beek RHT, Dubbink-Verheij GH, et al. Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study. Antibiotics. 2024; 13(6):537. https://doi.org/10.3390/antibiotics13060537
Chicago/Turabian Stylevan Veen, Liesanne E. J., Bo M. van der Weijden, Niek B. Achten, Lotte van der Lee, Jeroen Hol, Maaike C. van Rossem, Maarten Rijpert, Anna O. J. Oorthuys, Ron H. T. van Beek, Gerdien H. Dubbink-Verheij, and et al. 2024. "Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study" Antibiotics 13, no. 6: 537. https://doi.org/10.3390/antibiotics13060537