Background: Our aim was to compare risk factors, demographic and clinical characteristics of early onset sepsis (EOS) and community-acquired late onset sepsis (CA-LOS) in neonates.
Methods: Our medical center is the only hospital in southern-Israel, enabling population-based studies with incidence calculations. Neonatal EOS (
Results: Overall, 75 EOS and 127 CA-LOS episodes were recorded. The respective mean±SD annual rates per 1,000 live-births were 0.70±0.21 and 1.18±0.33. Prematurity (41.3% vs. 18.5%, p<0.001) and premature rupture of membrane (21.3% vs. 1.7%, p<0.001) were more common in EOS. Fever (78.0% vs. 26.9%, p<0.001) and hypothermia (13.0% vs. 3.0%, p=0.03) were common in CA-LOS, while leukopenia (29.7% vs. 10.4%, p<0.001) and thrombocytopenia (47.3% vs. 14.4%, p<0.001) were common in EOS. In both groups, Gram negative bacteria predominated (~60%). Streptococcus agalactiae was more common in EOS (22.7% vs. 8.7%, p=0.01), while pneumococcus was observed mainly in CA-LOS (13.4% vs. 1.3%, p=0.004). Longer mean hospitalization duration (23.0±24.4 vs. 12.0±16.3 days, p<0.001) and higher case fatality rate (20.0% vs. 5.5%, p=0.002) were noted in EOS episodes. All EOS and 95% of CA-LOS isolates were susceptible to empiric antibiotic treatment.
Conclusion Rates of EOS and CA-LOS are low in southern-Israel compared with other developed countries. EOS episodes were characterized by higher rates of perinatal risk factors. Fever and hypothermia were common in CA-LOS, while leukopenia and thrombocytopenia were common in EOS. Gram negative bacteria were common in both groups. Current empiric antibiotic treatment is effective.
