{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:53:36Z","timestamp":1790988816613,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Neonatal sepsis remains a challenge in perinatal medicine. We aimed to estimate incidence of culture positive early-onset sepsis (CP-EOS), causative pathogens and overall antibiotic exposure in newborn infants in Hungary.\u00a0Retrospective national registry analysis (2020\u20132023). Data were mainly collected from the Hungarian National Perinatal Registry covering all level II-III neonatal intensive care units (NICUs) in Hungary. The number of livebirths in each gestational age group was provided by Hungarian Central Statistical Office.\u00a0Overall CP-EOS incidence was 0.41\/1,000 livebirths (0.20\/1,000\u2009\u2265\u200935\u00a0weeks gestation, 7.0\/1,000\u2009&lt;\u200935\u00a0weeks gestation). Main pathogens were\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (33.3%) and Group B streptococci -GBS (24.5%). Ten of 49 (20.4%) infants with\n                    <jats:italic>E. coli<\/jats:italic>\n                    sepsis died. No GBS related mortality occurred. Lumbar puncture was only performed in 30\/147 (20.4%) of the CP-EOS cases. No cases of isolated meningitis occurred in the absence of CP-EOS. Newborns presenting with respiratory distress in the first 72\u00a0h were five times more likely to receive antibiotics (OR 4.9 CI 4.6\u20135.2) than infants without respiratory distress. Overall, 63.9% of NICU-treated neonates received antibiotics for a median (IQR) duration of 5 (3\u20138) days. A minimum of 3.2% of all neonates in Hungary received antibiotics, acknowledging that some more neonates are treated on postnatal wards and Level I NICUs which are not included in the perinatal registry. A substantial number (15.6%) of blood cultures were taken without subsequent antibiotic commencement.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    : Our results provide the first national incidence estimates for CP-EOS in Central-Eastern Europe. The study identified high antibiotic use with a concurrently relatively low EOS incidence. The results support implementing new strategies to reduce unnecessary antibiotic exposure in the newborn period.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Neonatal early-onset sepsis (EOS) causes substantial neonatal morbidity, prompting widespread, frequent empirical antibiotic use<\/jats:italic>\n                              .\u2022\n                              <jats:italic>Unnecessary early-life antibiotic exposure shifts the infant gut microbiota and increases risks for long-term adverse health outcomes<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\n                              <jats:italic>This first nationwide Central-Eastern European study reveals a low EOS incidence (0.41\/1,000 live births) but high NICU antibiotic exposure (63.9%) in Hungary<\/jats:italic>\n                              .\u2022\n                              <jats:italic>Escherichia coli has overtaken GBS as the leading EOS pathogen, causing significant mortality primarily in preterm infants<\/jats:italic>\n                              .\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-07455-8","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:51:36Z","timestamp":1790927496000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early-onset neonatal sepsis and neonatal antibiotic exposure in Hungary a nationwide population-based study"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-6116","authenticated-orcid":false,"given":"Judit","family":"Mari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Klingenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Rosa-Mangeret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S\u00e1ra","family":"Mlinarics","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"Szab\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Valek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit Kl\u00e1ra","family":"Kiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyula","family":"T\u00e1losi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"7455_CR1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/S0140-6736(24)00495-1","volume":"404","author":"T Strunk","year":"2024","unstructured":"Strunk T, Molloy EJ, Mishra A, Bhutta ZA (2024) Neonatal bacterial sepsis. 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