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Infectious Diseases

Poster Session 2

(551) Early Onset Neonatal Sepsis: Prevalence Of Bacterial Pathogens and Maternal Risk Factors

Tuesday, February 13, 2024

3:30 PM – 5:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Noam pardo, BSc, MD (he/him/his)

MFM Fellow
Sheba Medical Center, Tel Hashomer
Ramat hasharon, HaMerkaz, Israel

Coauthor(s)

AT

Abraham Tsur, MD

Director of the Women's Health Innovation Center, Deputy Chief Transformation Officer
Sheba Medical Center
Ramat-Gan, HaMerkaz, Israel
SA

Sharon Amit, MD, PhD

Head of the Microbiology Laboratory
Sheba Medical Center
Ramat-Gan, HaMerkaz, Israel
Yossi Bart, MD

Fellow
McGovern Medical School at UTHealth Houston
Houston, TX, United States
Anat Pardo, MD (she/her/hers)

OB/Gyn Specialist
Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva
Ramat Hasharon, Israel
BP

Ben Peleg, MD

Sheba Medical Center
Ramat-Gan, HaMerkaz, Israel
HK

Halit Kantor, MPH

Biostatistics
University of Haifa
Haifa, Hefa, Israel
RY

Rakefet Yoeli, MD

Sheba Medical Center, Tel-Hashomer
Kiriat Ono, HaMerkaz, Israel
SM

Shali Mazaki-Tovi, MD

Physician
Chaim Sheba Medical center, Tel HaShomer
Ramat Gan, HaMerkaz, Israel
Michal Fishel Bartal, MD (she/her/hers)

Maternal Fetal Medicine Faculty
McGovern Medical School at UTHealth Houston, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Houston, TX, United States

Objective: Early onset neonatal sepsis (EOS) is a rare yet life-threatening condition occurring in 1-2 neonates per 1000 live births. Diagnosis may be elusive, often leading to delay in treatment and, subsequently adverse neonatal consequences. This study aimed to describe risk factors, current pathogens, and outcomes associated with EOS

Study Design: This was a retrospective study of all live births (2013 to 2022) at a single tertiary center. EOS was diagnosed by a positive blood culture within 72 hours of delivery. Neonates with positive cultures of pathogens known to be contaminants were excluded (n= 131). The rate of maternal, delivery risk factors, and outcomes associated with EOS, were evaluated.

Results: Of 100,081 live births during the study period, EOS was diagnosed in 95 neonates (0.1%), with Escherichia Coli being the most common pathogen, followed by Viridans Streptococci and Group B Streptococci (n=29,30.5%; n=25,26.3%; n=11, 11.6%) respectively. There were no differences in maternal age, BMI, parity, induction rate between those with EOS compared to those without. Incidence of antenatal corticosteroids treatment, unknown GBS status, PPROM, prolonged rupture of membranes, intrapartum fever, and meconium-stained amniotic fluid were all more frequent in neonates with EOS. Of note 51% of individuals with neonatal EOS received antibiotics prior to delivery. As expected, neonates with EOS were more likely to be born via cesarean delivery, at an earlier gestational age and had a lower birth weight. However, 50% of EOS occurred at term, with 50% of neonates had a birthweight ≥ 2500g. Neonates with EOS were more prone to adverse neonatal outcome, with a median length of hospital stay of 25 days and a mortality rate of 7.4%. Mothers to neonates with EOS were more prone to postpartum hemorrhage, blood transfusion, and postpartum fever.

Conclusion: At a tertiary care center, EOS was uncommon but was associated with a high mortality rate. An improved understanding of modifiable risk factors and reassessment of preventative measures is warranted