title: Stable rates of neonatal sepsis in a tertiary neonatal unit.
abstract: OBJECTIVE
  To describe the rate of early- and late-onset sepsis in neonates admitted to the neonatal intensive care unit at the Royal Women's Hospital and to compare the rate of late-onset sepsis (LOS) with a published (2008) cohort from the same unit. The secondary aim was to examine clinicians' compliance with antibiotic guidelines.
  
  
  METHODS
  Infants born <32 weeks' gestation or <1500 g admitted between 1 July 2011 and 31 December 2011 were included. Strict definitions of sepsis and compliance with antibiotic guidelines were applied.
  
  
  RESULTS
  One hundred and seventy-two infants met the inclusion criteria, with 152 having blood culture evaluations for early-onset sepsis (EOS) and 58 having 109 evaluations for LOS. Definite EOS occurred in 1.3% with Escherichia coli isolated. The rate of definite LOS in 2011 of 22% was not significantly different than the 27% in 2008, with coagulase-negative staphylococcus the main isolate. Antibiotic continuation beyond 72 h in infants with negative blood cultures was the main reason for non-compliance with antibiotic guidelines.
  
  
  CONCLUSIONS
  The rate of EOS is comparable with published reports and the rate of LOS has remained stable over a 3-year period. Discontinuation of antibiotics with negative septic markers and blood cultures at 48-72 h is encouraged.
authors.affiliation: Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Wei Ling
authors.initials: WL
authors.lastname: Lean
authors.forename: Camille O
authors.initials: CO
authors.lastname: Kamlin
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.forename: Susan E
authors.initials: SE
authors.lastname: Jacobs
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001724:Birth Weight / Q000187:drug effects; D042241:Early Diagnosis; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013210:Staphylococcus / Q000302:isolation & purification; D016903:Drug Monitoring
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; early-onset sepsis; infant; late-onset sepsis; neonatal intensive care unit; preterm