This prospective surveillance study will be conducted over a 2 year period to determine current rates of Early-Onset Sepsis (EOS)/ Early-Onset Meningitis (EOM), associated pathogens, antimicrobial resistance, signs and symptoms and infant outcomes.
Neonatal pathogens other than group B Streptococcus (GBS) and resistant to beta-lactam antibiotics have emerged as the most common etiologic agents of EOS and EOM among preterm and term neonates and result in high mortality rates, potentially offsetting the decreased burden of early-onset GBS disease prevented by maternal intrapartum chemoprophylaxis. Primary Outcomes of this study: 1. To determine current hospital-based rates of early-onset neonatal infection (total, GA-specific and BW-specific, and pathogen-specific) in term and preterm infants in the era of maternal intrapartum antibiotic prophylaxis to prevent vertical transmission of group B streptococcal disease. Early-onset infection comprises EOS and/or EOM and is defined as isolation of a pathogen from blood or cerebrospinal fluid (CSF) obtained within 72 hours of birth and provision of appropriate antibiotic treatment for 5 or more days (or \<5 days if death occurs while receiving antibiotic therapy). 2. To determine the antimicrobial susceptibility patterns of organisms associated with EOS and EOM The case control aspect of this study will address 2 major conundrums regarding EOS: Can we identify risk factors for early-onset Gram-negative infections that might lead to intervention strategies to reduce risk and can we identify infants born to mothers with clinical chorioamnionitis who are at highest risk for early-onset sepsis and thus warrant antibiotic treatment soon after birth?
Study Type
OBSERVATIONAL
Enrollment
570
University of Alabama at Birmingham
Birmingham, Alabama, United States
To determine current hospital-based rates of early-onset neonatal infection
Time frame: First 72 hours
To determine the antimicrobial susceptibility patterns of organisms associated with EOS and EOM
Time frame: First 72 hours
To identify risk factors associated with EOS/EOM due to Gram-negative pathogens (case control comparison)
Time frame: First 72 hours
To determine the clinical signs/symptoms and laboratory abnormalities associated with EOS/EOM
Time frame: First 72 hours
To identify risk factors for EOS/EOM in infants born to mothers with chorioamnionitis (case control comparison)
Time frame: First 72 hours
To determine if term infants with EOS, identified because of maternal chorioamnionitis, can be asymptomatic at birth
Time frame: First 72 hours
To determine sepsis-associated mortality rates (total, GA-specific and BW-specific, pathogen-specific) for infants with EOS/EOM
Time frame: First 72 hours
To review changes over time in overall rates of EOS and EOM, pathogens associated with infection, risk factors for infection, clinical and laboratory abnormalities, and sepsis-associated mortality
Time frame: 9-11 years
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