Early-onset sepsis in Malaysian neonatal intensive care units.
Malays J Pathol
; 44(3): 443-459, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-36591712
ABSTRACT
OBJECTIVES:
To determine the incidence, causative pathogens, morbidities, mortality, and risk factors associated with blood culture-positive early-onset sepsis (EOS, ≤72 hours of age) in symptomatic neonates admitted to the neonatal intensive care units (NICUs) of a middle-income country. STUDYDESIGN:
Retrospective cohort study using data submitted prospectively to the Malaysian National Neonatal Registry (MNNR).SETTING:
44 Malaysian NICUs.PARTICIPANTS:
All neonates born in 2015- 2020.RESULTS:
EOS was reported in 991 neonates. The annual incidence of EOS increased from 0.46 to 0.49/1000 livebirths over the six years. The most common pathogen was Streptococcus agalactiae or Group B haemolytic streptococcus (GBS) (n=388, 39.2%), followed by Escherichia coli (E. coli) (n=80, 8.1%), Klebsiella spp (n=73, 7.4%), coagulase negative staphylococcus (CONS) (n=73, 7.4%), Pseudomonas spp (n=44, 4.4%) and methicillin-sensitive Staphylococcus aureus (n=34, 3.4%). The incidence of EOS due to GBS increased from 0.17 to 0.22/1000 livebirths. Morbidities and mortality were higher in those with EOS than without EOS. Multiple logistic regression analysis showed that Indian ethnic group, chorioamnionitis, gestation≥37weeks, female, spontaneous vaginal delivery, instrumental delivery, and surfactant therapy were significantly associated with increased risk of EOS due to GBS. Four factors were significantly associated with increased risk of non-GBS EOS (outborns, birthweight lt;1000 g, vaginal delivery, and surfactant therapy). Early continuous positive airway pressure was associated with significantly lower risk of EOS.CONCLUSION:
The incidence of EOS showed an increasing trend in Malaysian NICUs. GBS was the most common causative pathogen. Several modifiable risk factors associated with EOS have been identified.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sepse
/
Escherichia coli
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
Malays J Pathol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Malásia