Identifying Infants <32 Weeks' Gestation at Low Risk of Early-Onset Sepsis: A 10-Year Retrospective Study from Western Australia.

Cheryl Anne Mackay, Elizabeth A Nathan, Damber Shrestha, Tobias Strunk

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Article in Neonatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Cheryl Anne MackayNeonatology, Child and Adolescent Health Service, King Edward Memorial Hospital, Subiaco, Washington, Australia, cheryl.mackay@health.wa.gov.au.

Elizabeth A NathanSchool of Medicine, University of Western Australia, Crawley, Washington, Australia.

Damber ShresthaNeonatology, Child and Adolescent Health Service, King Edward Memorial Hospital, Subiaco, Washington, Australia.

Tobias StrunkNeonatology, Child and Adolescent Health Service, King Edward Memorial Hospital, Subiaco, Washington, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: Preterm infants are commonly treated with antibiotics on admission to the neonatal unit as part of routine care. We aimed to identify infants <32 weeks' gestation at low risk of early-onset sepsis (EOS) in whom antibiotics could be safely withheld.

methodsThis retrospective cohort study included infants <32 weeks' gestation admitted between January 2012 and June 2022. Data were extracted from electronic databases. Low risk for EOS (LR) was defined as caesarean section delivery, rupture of membranes <1 h prior to birth, no preterm labour and no features of maternal chorioamnionitis. Maternal and neonatal characteristics and neonatal outcomes were compared between LR and not low risk (NLR) infants. IBM SPSS Statistics (Version 29) was used for data analysis.

resultsThere were 3,285 infants included in the analysis of which 1,035 (31.5%) were LR and 2,250 (68.5%) NLR. No LR infants had culture-confirmed EOS compared with 35 (1.6%) NLR infants. Antibiotics were commenced in the first 48 h of life in 794 (76.7%) LR and 2,159 (96.0%) NLR infants (p < 0.001) and continued for ≥5 days in 226/782 (28.8%) LR and 603/2,107 (28.6%) NLR infants, despite negative blood cultures. There was no difference in mortality or late-onset sepsis between LR and NLR infants.

conclusionSimple clinical parameters available at birth can be used to identify very preterm infants at lower risk of EOS in whom withholding empiric antibiotics could be considered. </p>.

Indexed as

Anti-Bacterial AgentsInfant, PrematureNeonatal SepsisSepsisCesarean SectionFemaleGestational AgeHumansInfant, NewbornMalePregnancyPremature Rupture of Fetal MembranesRetrospective StudiesRisk AssessmentRisk FactorsWestern AustraliaAnti-Bacterial AgentsAntimicrobial stewardshipEarly-onset sepsisNeonatePrematurity

Identifiers

PMID41569955

DOI10.1159/000550519

PMCPMC12952855

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