Sepsis in neonatal intensive care in the late 1990s

Aim: To determine the incidence and clinical characteristics of sepsis in ventilated infants from an Australian neonatal intensive care unit (NICU) in the late 1990s. Methods: Demographic data was collected from babies requiring assisted ventilation (AV) over the 6-month period from 1 July to 31 December 1998. Sepsis was divided into early onset sepsis (EOS; ' 72 h of age) and late onset sepsis (LOS; >72 h of age), including both definite (culture-proven + abnormal markers) and probable (culture negative + abnormal markers) episodes. Results: Two hundred and eleven babies required AV over this period. Of these, 64 (30.3%) had at least one infection, with 85 episodes of sepsis (40.3 episodes per 100 admissions requiring AV). There were 22 babies with 22 episodes of EOS, and 45 with 63 episodes of LOS. Three babies had both EOS and LOS. The rate of EOS was 10.4 infected infants (10.4 infections per 100 admissions requiring AV). The rate of LOS was 21.3 infected infants (29.9 infections per 100 admissions requiring AV). The rates of both EOS and LOS were higher than previously reported by Australian studies in the early 1990s. In both EOS and LOS, risk factors for infection were common. Group B streptococcus was the commonest cause of definite EOS. The mortality rate from sepsis in the EOS group was 14% (3/22). Coagulase-negative staphylococci were the commonest cause of LOS. The mortality rate from sepsis in the LOS group was 11% (5/45). Conclusions: EOS and LOS are significant problems in ventilated NICU infants in the late 1990s.