Background and aims Neonatal infection is a major cause of morbidity and mortality. The ongoing Swiss Paediatric Sepsis Study prospectively evaluates the epidemiology of blood culture-proven sepsis in newborns and children in Switzerland.
Methods Newborn infants admitted to nine Swiss neonatal intensive care units (NICUs) and presenting with culture-proven sepsis between 9.2011–2.2014 were prospectively enrolled. Early-onset sepsis (EOS) was defined as infection occurring.
Results We identified 189 episodes of blood culture-proven sepsis in 186 patients. Thirty seven episodes were classified as EOS and 152 episodes were classified as LOS. Median gestational age at birth was 34 weeks for EOS, and 28 weeks for LOS. Mortality was 14% in EOS and 9% in LOS. Forty six percent of patients required mechanical ventilation during the sepsis episode, and 4% required catecholamine treatment for arterial hypotension.
Group B Streptococcus (GBS) and Escherichia coli were the most frequently isolated pathogens in EOS, accounting for 35% and 16% of episodes. Coagulase-negative staphylococci were the leading pathogens in LOS (36%), followed by Staphylococcus aureus (18%), Escherichia coli (16%), and GBS (11%). The proportion of hospital-acquired LOS due to Coagulase-negative staphylococci, Staphylococcus aureus and Escherichia coli varied between 10–68%, 0–45% and 0–30% in different NICUs.
Conclusions This national study confirms that neonatal sepsis continues to cause high morbidity and significant mortality. GBS is the most common cause of EOS. There are important differences in the aetiology of LOS in different institutions.