Estimating the National Burden of Early Onset Neonatal Sepsis Open Access

Shane, Andi L (2009)

Permanent URL: https://etd.library.emory.edu/concern/etds/zg64tm726?locale=en
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Abstract

Estimating the National Burden of Neonatal Early Onset Sepsis
By Andrea L. Shane, M.D., MPH

Bacterial sepsis of the newborn is a notable etiology of mortality. Infections classified as early-onset sepsis (EOS) are evident within the first 72 hours of life. We performed a retrospective secondary data analysis by applying incidence rates derived from an active laboratory and population-based surveillance system to national natality data to estimate the national pathogen-specific and all-cause incidence rates of neonatal early onset sepsis. We estimated that 3183 cases of EOS occurred in 2005 (0.77 cases per 1,000 live births), 2898 in 2006 (0.79 cases per 1,000 live births), and 3195 in 2007 (0.74 cases per 1,000 live births), for an average of 3092 cases of EOS (0.77 cases per 1,000 live births) annually during each of the years 2005-2007. Black preterm infants had the highest incidence of all cause EOS annually. An overall case fatality rate (CFR) of 9.5% was calculated from ABCs NNS data. The CFR from 2005-2007 was greatest for Black preterm neonates, (21-33%) compared with their non- Black preterm counterparts (15-17%). Black and non-Black preterm infants had the highest incidence of both ampicillin-sensitive (0.54 and 0.56 per 1,000 live births) and ampicillin-resistant E.coli (1.03 and 0.45 per 1,000 live births) isolates during each of the years from 2005-2007. This assessment highlights a racial and gestational age predisposition for EOS. Understanding these risk factors could translate into improved maternal and infant health.

Table of Contents

Section Pages
Introduction...1
Background...4
Methods...6
Null Hypothesis...6
Study Design...6
Data Sources and Subjects...6
Statistical Analysis...9
Results...10
Discussion and Conclusions...13
References...19
Tables...22

Table 1: Percentages of Births by Race/Gestational age from the Active Bacterial Core Surveillance (ABCs) and from the National Vital Statistics System (2005-2007)...22
Table 2. National Estimates of Early Onset Sepsis (EOS) by Race and Gestational Age Categories...23
Table 3: Case Fatality Rates (CFR) Due to Early Onset Sepsis (EOS) by Race and Gestational Age Categories...24
Table 4: Pathogen Specific Early Onset Sepsis (EOS) by Race and Gestational Age Categories for 2005-2007...25
Table 5: Antimicrobial Sensitive and Resistant EOS E. coli by Race and Gestational Age Categories for 2005-2007...26

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