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Stable rates of neonatal sepsis in a tertiary neonatal unit

Authors

  • Wei Ling Lean,

    Corresponding author
    1. Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
    • Correspondence: Dr Wei Ling Lean, Neonatal Services, Level 5, Royal Women's Hospital, 20 Flemington Road, Parkville, Vic. 3052, Australia. Fax: +61 3 83453588; email: weiling.lean@thewomens.org.au

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  • Camille O Kamlin,

    1. Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    3. Department of Obstetrics and Gynaecology (Royal Women's Hospital), University of Melbourne, Melbourne, Victoria, Australia
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  • Suzanne M Garland,

    1. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Department of Obstetrics and Gynaecology (Royal Women's Hospital), University of Melbourne, Melbourne, Victoria, Australia
    3. Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, Victoria, Australia
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  • Susan E Jacobs

    1. Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    3. Department of Obstetrics and Gynaecology (Royal Women's Hospital), University of Melbourne, Melbourne, Victoria, Australia
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  • Conflicts of interest: The authors have no conflicts of interest to declare.

Abstract

Aims

To describe the rate of early- and late-onset sepsis in neonates admitted to the neonatal intensive care unit at the Royal Women's Hospital and to compare the rate of late-onset sepsis (LOS) with a published (2008) cohort from the same unit. The secondary aim was to examine clinicians' compliance with antibiotic guidelines.

Methods

Infants born <32 weeks' gestation or <1500 g admitted between 1 July 2011 and 31 December 2011 were included. Strict definitions of sepsis and compliance with antibiotic guidelines were applied.

Results

One hundred and seventy-two infants met the inclusion criteria, with 152 having blood culture evaluations for early-onset sepsis (EOS) and 58 having 109 evaluations for LOS. Definite EOS occurred in 1.3% with Escherichia coli isolated. The rate of definite LOS in 2011 of 22% was not significantly different than the 27% in 2008, with coagulase-negative staphylococcus the main isolate. Antibiotic continuation beyond 72 h in infants with negative blood cultures was the main reason for non-compliance with antibiotic guidelines.

Conclusions

The rate of EOS is comparable with published reports and the rate of LOS has remained stable over a 3-year period. Discontinuation of antibiotics with negative septic markers and blood cultures at 48–72 h is encouraged.

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