Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli , and the Need for Novel Prevention Strategies

作者：Barbara J. Stoll, Karen Marie Puopolo, Nellie I. Hansen, Pablo J. Sánchez, Edward F. Bell, Waldemar A. Carlo, Charles Michael Cotten, Carl T. D’Angio, S. Nadya J. Kazzi, Brenda Bradley Poindexter, Krisa P. Van Meurs, Ellen C. Hale, Monica V. Collins, Abhik Das, Carol J. Baker, Myra Helen Wyckoff, Bradley A. Yoder, Kristi L. Watterberg, Michele C. Walsh, Uday P. Devaskar, Abbot R. Laptook, Gregory M. Sokol, Stephanie J. Schrag, Rosemary D. Higgins · 发表于：Archives of Pediatrics and Adolescent Medicine · 年份：2020 · DOI：10.1001/jamapediatrics.2020.0593 · 被引用次数：406 · 研究领域：Neonatal and Maternal Infections、Sepsis Diagnosis and Treatment、Preterm Birth and Chorioamnionitis

Importance: Early-onset sepsis (EOS) remains a potentially fatal newborn condition. Ongoing surveillance is critical to optimize prevention and treatment strategies. Objective: To describe the current incidence, microbiology, morbidity, and mortality of EOS among a cohort of term and preterm infants. Design, Setting, and Participants: This prospective surveillance study included a cohort of infants born at a gestational age (GA) of at least 22 weeks and birth weight of greater than 400 g from 18 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network from April 1, 2015, to March 31, 2017. Data were analyzed from June 14, 2019, to January 28, 2020. Main Outcomes and Measures: Early-onset sepsis defined by isolation of pathogenic species from blood or cerebrospinal fluid culture within 72 hours of birth and antibiotic treatment for at least 5 days or until death. Results: A total of 235 EOS cases (127 male [54.0%]) were identified among 217 480 newborns (1.08 [95% CI, 0.95-1.23] cases per 1000 live births). Incidence varied significantly by GA and was highest among infants with a GA of 22 to 28 weeks (18.47 [95% CI, 14.57-23.38] cases per 1000). No significant differences in EOS incidence were observed by sex, race, or ethnicity. The most frequent pathogens were Escherichia coli (86 [36.6%]) and group B streptococcus (GBS; 71 [30.2%]). E coli disease primarily occurred among preterm infants (68 of 131 [51.9%]); GB...