{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T22:54:54Z","timestamp":1774738494992,"version":"3.50.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Difficulty identifying neonates at highest risk of early-onset bloodstream infection (EO-BSI) leads to high empiric antibiotic use. This retrospective case-control study analysed maternal and neonatal factors, pathogen profile, and outcomes of culture-confirmed EO-BSI (&amp;lt;72\u2009hr of life) at a large neonatal unit in Cape Town, South Africa (1 January 2019\u201331 December 2021). Cases (neonates with culture-confirmed BSI) were matched 1:3 with randomly selected controls (\u2018at risk\u2019 neonates with negative blood cultures, C-reactive protein &amp;lt; 10\u2009mg\/l and \u22644\u2009days of antibiotics). Factors associated with EO-BSI were identified using multivariable logistic regression. Among 248 neonates included, 62 were cases and 186 were controls. Six factors independently predicted EO-BSI in \u2018at risk\u2019 neonates: \u226532 maternal risk factors; birth weight &amp;gt; 2500\u2009g; hypo\/hyperglycaemia; abnormal perfusion; seizures and invasive respiratory support. Group B streptococcus and Escherichia coli predominated on birth blood cultures (25\/44; 56.8%), whereas Klebsiella. pneumoniae was dominant from 24 to 72\u2009hr of life (13\/20; 65%). Ampicillin plus gentamicin was the most frequently prescribed empiric regimen (82% in cases, 100% in controls), followed by regimens targeting healthcare-associated pathogens \u2265 24\u2009hr of life. Cases were nearly 6 times more likely to demise than controls (RR 5.8, 95% CI\u2009=\u20092.7\u201312.5; case fatality rate 32.5%). Mortality was strongly associated with gram-negative pathogens, discordant antibiotic treatment and gestational age &amp;lt; 32\u2009weeks. A clinical score to evaluate EO-BSI risk may reduce early-life antibiotic exposure. Beyond 24\u2009hr of life, empiric antibiotics should provide coverage of healthcare-associated pathogens.<\/jats:p>","DOI":"10.1093\/tropej\/fmaf030","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:51:05Z","timestamp":1751529065000},"source":"Crossref","is-referenced-by-count":0,"title":["Predictors, aetiology and outcome of early-onset neonatal bloodstream infection: a case-control study in a tertiary hospital in South Africa"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5440-0283","authenticated-orcid":false,"given":"Elisabeth","family":"Laurer","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Johannes Kepler University Linz , Linz, 4020,","place":["Austria"]},{"name":"Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, 7505,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrie","family":"Bekker","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, 7505,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaqilah","family":"Fataar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, 7505,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew Christopher","family":"Whitelaw","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Immunology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, 7505,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Dramowski","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, 7505,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"2026032818451526100_fmaf030-B1","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1136\/ARCHDISCHILD-2020-320217","article-title":"Global incidence and mortality of neonatal sepsis: a systematic review and meta-analysis","volume":"106","author":"Fleischmann","year":"2021","journal-title":"Arch Dis Child"},{"key":"2026032818451526100_fmaf030-B2","doi-asserted-by":"publisher","first-page":"S67","DOI":"10.3346\/JKMS.2015.30.S1.S67","article-title":"Blood culture proven early onset sepsis and late onset sepsis in very-low-birth-weight infants in 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