Pattern of culture-proven neonatal sepsis in a district general hospital in the United Kingdom

Infect Control Hosp Epidemiol. 2004 Sep;25(9):759-64. doi: 10.1086/502473.


Objective: To determine the incidence, clinical characteristics, and risk factors associated with the first culture-proven episode of sepsis among neonates in a neonatal intensive care unit (NICU).

Setting: Level-II NICU in the United Kingdom.

Patients: Neonates with their first culture-proven sepsis between January 1, 1996, and December 31, 2000.

Methods: Demographic data were obtained from the NICU database and chart review. Sepsis was considered early (EOS; < 72 hours old) or late (LOS; > 72 hours old). Data were also collected on potential risk factors.

Results: Among 14,767 live births, 1,612 (11%) neonates were admitted to the NICU during the study period. Nine hundred eight were screened for sepsis. One hundred twenty-four had at least one positive culture (overall sepsis rate of 8.4 per 1,000 live births [1%] or 77 per 1,000 NICU admissions). Twenty-four neonates had EOS and 100 had LOS. Coagulase-negative staphylococci (CoNS) and group B Streptococcus were the most frequent organisms causing EOS, whereas CoNS and Escherichia coli most frequently caused LOS. Birth before 30 weeks' gestation and birth weight less than 1,500 g were risk factors for sepsis. Resuscitation at birth was the leading risk factor for EOS and respiratory support prior to sepsis, presence of a central or peripheral catheter, and total parenteral nutrition were leading risk factors for LOS.

Conclusions: A strong inverse relationship existed between gestational age of 30 weeks or younger and birth weight of 1,500 g or less and LOS. Resuscitation and indwelling intravenous catheters were also risk factors.

MeSH terms

  • Cell Culture Techniques
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Hospitals, District
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Population Surveillance
  • Risk Factors
  • Sepsis / epidemiology*
  • Sepsis / microbiology
  • Sepsis / prevention & control
  • United Kingdom / epidemiology