Objective: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS. Methods: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed. Results: Live births (LB) numbered 146 682. Ninety neonates had EOS and 12 died (incidence rates of 0.61 and 0.08/1000 LB, respectively). EOS and mortality were the highest among neonates with a birth weight51000 g (20.37/1000 LB and 8.49/1000 LB, respectively). The most common pathogens were GBS (n¼27, 0.18/1000 LB) and Escherichia coli (n¼19, 0.13/1000 LB). Most infants affected by E. coli EOS were born preterm (n¼13), had complications (n¼4) or died (n¼7). Among 90 isolates tested, only 3 were resistant to both first line empirical antibiotics. Multivariate logistic regression analysis showed that low gestational age, caesarean section and low platelet count at presentation were significantly associated with death or brain lesions (area under ROC curve¼0.939, H-L¼0.944, sensitivity 76.0%, specificity 90.7%). Conclusions: GBS slightly exceeds E. coli as a cause of EOS. However, E. coli is the prominent cause of death, complications and in most cases affects preterm neonates. Empirical antimicrobial therapy of EOS seems appropriate
The burden of early-onset sepsis in Emilia- Romagna (Italy): a 4-year, population-based study / Alberto, Berardi; Lorenza, Baroni; Maria Letizia Bacchi, Reggiani; Simone Ambretti, ; Biasucci, G; Serenella, Bolognesi; Maria Grazia, Capretti; Edoardo, Carretto; Matilde, Ciccia; Valentina, Fiorini; Cinzia, Fortini; Giancarlo Gargano, ; Maria Federica, Pedna; Vittoria, Rizzo; Roberta, Creti; Fabrizio Ferrari & on Behalf of the GBS Prevention Working Group, Emilia-Romagna. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-4954. - 29:(2016), pp. 3126-3131. [10.3109/14767058.2015.1114093]
The burden of early-onset sepsis in Emilia- Romagna (Italy): a 4-year, population-based study
Biasucci G;
2016-01-01
Abstract
Objective: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS. Methods: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed. Results: Live births (LB) numbered 146 682. Ninety neonates had EOS and 12 died (incidence rates of 0.61 and 0.08/1000 LB, respectively). EOS and mortality were the highest among neonates with a birth weight51000 g (20.37/1000 LB and 8.49/1000 LB, respectively). The most common pathogens were GBS (n¼27, 0.18/1000 LB) and Escherichia coli (n¼19, 0.13/1000 LB). Most infants affected by E. coli EOS were born preterm (n¼13), had complications (n¼4) or died (n¼7). Among 90 isolates tested, only 3 were resistant to both first line empirical antibiotics. Multivariate logistic regression analysis showed that low gestational age, caesarean section and low platelet count at presentation were significantly associated with death or brain lesions (area under ROC curve¼0.939, H-L¼0.944, sensitivity 76.0%, specificity 90.7%). Conclusions: GBS slightly exceeds E. coli as a cause of EOS. However, E. coli is the prominent cause of death, complications and in most cases affects preterm neonates. Empirical antimicrobial therapy of EOS seems appropriateI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
