Management of early onset neonatal sepsis differs in the north and south of Scandinavia

Aim: This study compared the management and outcomes of early-onset neonatal sepsis (EONS) in two tertiary neonatal units in Denmark and Norway. Methods: We retrospectively studied all infants diagnosed with EONS between April 2010 and March 2013 and managed at Odense University Hospital, Denmark, a...

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Bibliographic Details
Published in:Acta Paediatrica
Main Authors: Drageset, Martin, Fjalstad, Jon Widding, Mortensen, Sven, Klingenberg, Claus
Format: Article in Journal/Newspaper
Language:English
Published: 2017
Subjects:
Antibiotics
C-reactive protein
Early-onset neonatal sepsis
Lumbar puncture
Staphylococcus aureus
Denmark/epidemiology
Humans
Norway/epidemiology
Retrospective Studies
Anti-Bacterial Agents/therapeutic use
Infant
Newborn
Neonatal Sepsis/drug therapy
North Norway
Online Access:https://portal.findresearcher.sdu.dk/da/publications/f0347e03-32df-4fb5-8746-2cd04e36ec62
https://doi.org/10.1111/apa.13698
Description
Summary:Aim: This study compared the management and outcomes of early-onset neonatal sepsis (EONS) in two tertiary neonatal units in Denmark and Norway. Methods: We retrospectively studied all infants diagnosed with EONS between April 2010 and March 2013 and managed at Odense University Hospital, Denmark, and the University Hospital of North Norway, Norway. Clinical and laboratory data were collected from patient records. Results: We identified 137 EONS cases in Denmark and 101 in Norway. There were 35 culture-confirmed EONS cases: 16% of the Danish cases and 13% of the Norwegian cases. Staphylococcus aureus was the most frequently detected pathogen in 11 cases (31%), followed by Group B streptococci in nine (26%) and Escherichia coli in six (17%). In 85% of the 238 cases, the empiric therapy comprised gentamicin and a beta-lactam, namely ampicillin in Denmark and benzylpenicillin in Norway. Patients with positive blood cultures had higher C-reactive protein levels than patients with negative blood cultures and higher sepsis-attributable mortality. Lumbar punctures were performed more frequently in Denmark. Conclusion: There were marginal differences in the management of EONS between units in Denmark and Norway, mainly in their choice of antibiotics and the use of lumbar punctures. Staphylococcus aureus was the most common pathogen.

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