Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship.

IF 2.3 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2026-08-21 DOI:10.1038/s41372-026-02879-4

Alessandra Guiterrez, Imran Mir, Katherine Stumpf, Leslee M Roberts, Natasha W Hanners, L Steven Brown, Julide Sisman

{"title":"Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship.","authors":"Alessandra Guiterrez, Imran Mir, Katherine Stumpf, Leslee M Roberts, Natasha W Hanners, L Steven Brown, Julide Sisman","doi":"10.1038/s41372-026-02879-4","DOIUrl":null,"url":null,"abstract":"Objective: To identify risk factors for early-onset sepsis (EOS) in extremely preterm infants.Study design: This retrospective study included 554 infants at 22-296/7 weeks' gestation at Parkland Hospital Dallas, Texas, from 2018 to 2023. Proven EOS was defined by positive blood culture within 72 hours after birth; suspected EOS by ≥5 days of antibiotics despite negative cultures. Remaining infants served as controls. Maternal, neonatal, delivery, and placental characteristics were compared. Low EOS risk was defined as cesarean delivery without labor, rupture of membranes (ROM) at delivery, and no chorioamnionitis.Results: Prelabor preterm ROM and acute chorioamnionitis on placental pathology were more common among the infants with EOS than those with suspected sepsis and controls (P = 0.02; OR 5.5, 95% CI 1.43-21, P = 0.01, respectively). None of the infants with proven EOS were classified as low risk.Conclusion: Risk assessment for EOS should be promoted to enhance antibiotic stewardship.","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41372-026-02879-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To identify risk factors for early-onset sepsis (EOS) in extremely preterm infants.

Study design: This retrospective study included 554 infants at 22-29^6/7 weeks' gestation at Parkland Hospital Dallas, Texas, from 2018 to 2023. Proven EOS was defined by positive blood culture within 72 hours after birth; suspected EOS by ≥5 days of antibiotics despite negative cultures. Remaining infants served as controls. Maternal, neonatal, delivery, and placental characteristics were compared. Low EOS risk was defined as cesarean delivery without labor, rupture of membranes (ROM) at delivery, and no chorioamnionitis.

Results: Prelabor preterm ROM and acute chorioamnionitis on placental pathology were more common among the infants with EOS than those with suspected sepsis and controls (P = 0.02; OR 5.5, 95% CI 1.43-21, P = 0.01, respectively). None of the infants with proven EOS were classified as low risk.

Conclusion: Risk assessment for EOS should be promoted to enhance antibiotic stewardship.

查看原文本刊更多论文

极早产儿早发性脓毒症的风险评估：抗生素管理的意义。

目的：探讨极早产儿早发性脓毒症（EOS）的危险因素。研究设计：本回顾性研究包括2018年至2023年在德克萨斯州达拉斯帕克兰医院妊娠22-296/7周的554名婴儿。出生后72小时内血培养阳性为确诊EOS；尽管培养呈阴性，但仍被抗生素怀疑为EOS≥5天。剩下的婴儿作为对照。比较产妇、新生儿、分娩和胎盘的特征。低EOS风险定义为无分娩、分娩时膜破裂（ROM）、无绒毛膜羊膜炎的剖宫产。结果：产前早产ROM和胎盘病理上的急性绒毛膜羊膜炎在EOS患儿中较疑似脓毒症患儿和对照组更为常见（P = 0.02; OR = 5.5, 95% CI 1.43 ~ 21, P = 0.01）。没有一个确诊为EOS的婴儿被归为低风险。结论：应加强对EOS的风险评估，以加强抗生素的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.