@article {Duggan31, author = {Husharn L Duggan and Sharon S W Chow and Nicola C Austin and Prakeshkumar S Shah and Kei Lui and Kenneth Tan}, editor = {, and , and Morris, Scott and Schmidt, Peter and Korostenski, Larissa and Sharp, Mary and Gill, Andy and Pillow, Jane and Stack, Jacqueline and Birch, Pita and Nothdurft, Karen and Casalaz, Dan and Holberton, Jim and Stewart, Alice and Hunt, Rod and Cooke, Lucy and Downe, Lyn and Stewart, Michael and Berry, Andrew and Hickey, Leah and Morris, Peter and Paoli, Tony De and Spotswood, Naomi and Bolisetty, Srinivas and Lui, Kei and Paradisis, Mary and Greenhalgh, Mark and Koorts, Pieter and Kuschel, Carl and Doyle, Lex and Craven, John and Collins, Clare and Numa, Andrew and Carlisle, Hazel and Badawi, Nadia and Popat, Himanshu and Koh, Guan and Davis, Jonathan and Luig, Melissa and Headley, Bevan and Andersen, Chad and Austin, Nicola and Darlow, Brian and Edmonds, Liza and Mildenhall, Lindsay and Buksh, Mariam and Battin, Malcolm and Boom, Jutta vanden and Richardson, Vaughan and Chambers, Georgina and Rajadurai, Victor Samuel and Barker, David and Dhawan, Anjali and Hammond, Barbara and Merida, Natalie and Ng, Linda}, title = {Early-onset sepsis in very preterm neonates in Australia and New Zealand, 2007{\textendash}2018}, volume = {108}, number = {1}, pages = {31--37}, year = {2023}, doi = {10.1136/archdischild-2021-323243}, publisher = {BMJ Publishing Group}, abstract = {Objective To evaluate the epidemiology and population trends of early-onset sepsis in very preterm neonates admitted to neonatal intensive care units (NICU) in Australia and New Zealand.Design Retrospective observational cohort study using a dual-nation registry database.Setting 29 NICUs that have contributed to the Australian and New Zealand Neonatal Network.Participants Neonates born at \<32 weeks{\textquoteright} gestation born between 2007 and 2018 and then admitted to a NICU.Main outcome measures Microorganism profiles, incidence, mortality and morbidity.Results Over the 12-year period, 614 early-onset sepsis cases from 43 178 very preterm admissions (14.2/1000 admissions) were identified. The trends of early-onset sepsis incidence remained stable, varying between 9.8 and 19.4/1000 admissions (linear trend, p=0.56). The leading causative organisms were Escherichia coli (E. coli) (33.7\%) followed by group B Streptococcus (GBS) (16.1\%). The incidence of E. coli increased between 2007 (3.2/1000 admissions) and 2018 (8.3/1000 admissions; p=0.02). Neonates with E. coli had higher odds of mortality compared with those with GBS (OR=2.8, 95\% CI 1.2 to 6.1). Mortality due to GBS decreased over the same period (2007: 0.6/1000 admissions, 2018: 0.0/1000 admissions; p=0.01). Early-onset sepsis tripled the odds of mortality (OR=3.0, 95\% CI 2.4 to 3.7) and halved the odds of survival without morbidity (OR=0.5, 95\% CI 0.4 to 0.6).Conclusion Early-onset sepsis remains an important condition among very preterm populations. Furthermore, E. coli is a dominant microorganism of very preterm early-onset sepsis in Australia and New Zealand. Rates of E. coli have been increasing in recent years, while GBS-associated mortality has decreased.All data relevant to the study are included in the article or uploaded as supplementary information.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/108/1/31}, eprint = {https://fn.bmj.com/content/108/1/31.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }