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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants
Barbara J Stoll1, Nellie Hansen, Avroy A Fanaroff
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
The New England Journal of Medicine
|July 26, 2002
Summary
Early-onset sepsis in very-low-birth-weight infants remains a serious concern. While group B strep rates decreased, E. coli infections increased, with many strains resistant to ampicillin.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Public Health
Background:
- The changing epidemiology of early-onset sepsis (EOS) in very-low-birth-weight (VLBW) infants is unclear.
- Increased intrapartum antibiotic use may influence EOS rates and causative pathogens.
Purpose of the Study:
- To investigate trends in the rates and causes of EOS among VLBW infants.
- To compare EOS in VLBW infants born between 1991-1993 and 1998-2000.
Main Methods:
- Retrospective cohort study of 5447 VLBW infants (1998-2000) and 7606 VLBW infants (1991-1993).
- Inclusion criteria: birth weight 401-1500g, at least one blood culture within 72 hours of birth.
- Data collected on sepsis pathogens, antimicrobial resistance, and maternal antibiotic exposure.
Main Results:
- Overall EOS rate remained stable (1.5% in 1998-2000 cohort).
- Group B Streptococcus sepsis decreased significantly (5.9 to 1.7 per 1000), while E. coli sepsis increased (3.2 to 6.8 per 1000).
- 85% of recent E. coli isolates were ampicillin-resistant; maternal intrapartum ampicillin use was linked to resistant E. coli infections.
Conclusions:
- Early-onset sepsis is an uncommon but life-threatening condition in VLBW infants.
- A shift from gram-positive to gram-negative pathogens, particularly ampicillin-resistant E. coli, is observed.
- Ongoing surveillance is crucial to monitor evolving pathogen trends and guide treatment strategies.
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