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Pattern of Culture-Proven Neonatal Sepsis in a District General Hospital in the United Kingdom

Published online by Cambridge University Press:  02 January 2015

Khalid N. Haque ,
M. Ajaz Khan ,
Sally Kerry ,
Jim Stephenson  and
Gretta Woods
Khalid N. Haque*
Affiliation:
St. Helier University Hospital, Surrey, England
M. Ajaz Khan
Affiliation:
St. Helier University Hospital, Surrey, England
Sally Kerry
Affiliation:
St. Helier University Hospital, Surrey, England
Jim Stephenson
Affiliation:
St. Helier University Hospital, Surrey, England
Gretta Woods
Affiliation:
St. Helier University Hospital, Surrey, England
*
St. Helier University Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, England
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Abstract

Objective:

To determine the incidence, clinical characteristics, and risk factors associated with the first culture-proven episode of sepsis among neonates in a neonatal intensive care unit (NICU).

Setting:

Level-II NICU in the United Kingdom.

Patients:

Neonates with their first culture-proven sepsis between January 1, 1996, and December 31, 2000.

Methods:

Demographic data were obtained from the NICU database and chart review. Sepsis was considered early (EOS; < 72 hours old) or late (LOS; > 72 hours old). Data were also collected on potential risk factors.

Results:

Among 14,767 live births, 1,612 (11%) neonates were admitted to the NICU during the study period. Nine hundred eight were screened for sepsis. One hundred twenty-four had at least one positive culture (overall sepsis rate of 8.4 per 1,000 live births [1%] or 77 per 1,000 NICU admissions). Twenty-four neonates had EOS and 100 had LOS. Coagulase-negative staphylococci (CoNS) and group B Streptococcus were the most frequent organisms causing EOS, whereas CoNS and Escherichia coli most frequently caused LOS. Birth before 30 weeks' gestation and birth weight less than 1,500 g were risk factors for sepsis. Resuscitation at birth was the leading risk factor for EOS and respiratory support prior to sepsis, presence of a central or peripheral catheter, and total parenteral nutrition were leading risk factors for LOS.

Conclusions:

A strong inverse relationship existed between gestational age of 30 weeks or younger and birth weight of 1,500 g or less and LOS. Resuscitation and indwelling intravenous catheters were also risk factors.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 759 - 764
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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