Affiliations: [a] Division of Neonatology, China Medical University Children’s Hospital, China Medical University, Taichung, Taiwan
| [b] Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| [c] Department of Long Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Taiwan
| [d] College of Medicine, China Medical University, Taichung, Taiwan
| [e] Department of Pediatrics, Asia University Hospital, Asia University, Taichung, Taiwan
Correspondence:
[*]
Address for correspondence: Hung-Chih Lin, Department of Pediatrics, Asia University Hospital,
Asia University, Taichung, Taiwan. Tel.: +886 4 22052121/ext.: 2062.2656; +886932563999 (cell);
Fax: +886 4 22032798; E-mail: [email protected].
Abstract: BACKGROUND:We aimed to explore the epidemiology and evolution of pathogens, antibiotic susceptibility, and mortality rate in cases of neonatal early-onset sepsis (EOS) reported over a period of 12 years in a level III neonatal center in Central Taiwan. METHODS:Patients’ medical records in a neonatal center from 2007 to 2018 were reviewed to obtain information on infants with culture-proven EOS, which included pathogens found in the blood or cerebrospinal fluid cultures. RESULTS:The incidence of neonatal EOS during this period was 2.11 cases/1,000 admissions. Group B streptococcal (GBS) and Escherichia coli were the most common pathogens. The overall rates of GBS and E. coli infections were 0.68/1,000 and 0.77/1,000 live births, respectively. The incidence of EOS in infants with a birth weight ≥1,500 g decreased significantly with decreasing incidence of GBS-related sepsis. The incidence of EOS remained high in very-low-birth-weight (VLBW) infants and increased over time. There was an increasing trend in of E. coli infection and emergence of drug-resistant strains. In addition, E. coli sepsis had high mortality in VLBW infants. CONCLUSION:Novel screening and prevention strategies against E. coli and reserving broad-spectrum antibiotics for the most critically ill or VLBW patients with maternal chorioamnionitis might help in early diagnosis and further improve the outcomes of EOS.
Keywords: Neonatal early-onset sepsis, Escherichia coli, Group B Streptococcus
