{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:32:08Z","timestamp":1766158328644,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Early\u2010onset neonatal sepsis (EOS) may lead to significant morbidity and mortality, yet the recommended antimicrobials have not changed for many years. We aimed to optimise EOS treatment by examining EOS pathogens, resistance rates and resistance risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, nationwide cohort study analysing 2010\u20102015 EOS data in Israel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 21 participating centres constitute 92% of the total birth cohort (around 180\u00a0000 live births\/year). Of 549 EOS neonates (0.57\/1000 live births), 306 (56%) and 243 (44%) were full\u2010term and preterm, respectively (0.35 vs. 2.94 per\/1000 live births). Gram\u2010negative pathogens predominated, especially in preterms. <jats:italic>Escherichia coli<\/jats:italic> and <jats:italic>Streptococcus agalactiae<\/jats:italic> were most common pathogens (0.2 and 0.19 per 1000 live births, respectively). In 277 Gram\u2010negatives, 16%, 14%, 8% and 3% were gentamicin\u2010resistant, extended\u2010spectrum beta\u2010lactamase (ESBL)\u2010positive, gentamicin\u2010resistant and ESBL\u2010positive, and amikacin\u2010resistant, respectively; preterms had higher resistance rates. No risk factors for antimicrobial resistance were identified. Mortality was reported in 21% of Gram\u2010negative EOS versus 7% of Gram\u2010positive EOS [OR 3.4 (95% CI 1.8\u20106.2), p\u00a0&lt;\u00a00.01].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this nationwide study, EOS was caused predominantly by Gram\u2010negatives, with high gentamicin resistance and ESBL phenotype rates, without identifiable resistance risk factors. As EOS is life\u2010threatening, modification of empiric therapy for amikacin\u2010based regimens should be considered, mainly in preterms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14889","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T05:18:41Z","timestamp":1559798321000},"page":"2192-2198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Nationwide epidemiology of early\u2010onset sepsis in Israel 2010\u20102015, time to re\u2010evaluate empiric treatment"],"prefix":"10.1111","volume":"108","author":[{"given":"Daniel","family":"Glikman","sequence":"first","affiliation":[{"name":"The Azrieli Faculty of Medicine in the Galilee Bar\u2010Ilan University Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitzan","family":"Curiel","sequence":"additional","affiliation":[{"name":"The Azrieli Faculty of Medicine in the Galilee Bar\u2010Ilan University Safed Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aharona","family":"Glatman\u2010Freedman","sequence":"additional","affiliation":[{"name":"Israel Centre for Disease Control Tel Hashomer Ramat  Gan Israel"},{"name":"Sackler School of Medicine Tel Aviv University Tel\u2010Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orli","family":"Megged","sequence":"additional","affiliation":[{"name":"Paediatrics Shaare Zedek Medical Center Jerusalem Israel"},{"name":"The School of Medicine The Hebrew University and Hadassah Medical Centre Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilan","family":"Youngster","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine Tel Aviv University Tel\u2010Aviv Israel"},{"name":"Paediatrics, Centre for Microbiome Research Assaf Harofeh Medical Centre Zerifin Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4019-7146","authenticated-orcid":false,"given":"Ronella","family":"Marom","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine Tel Aviv University Tel\u2010Aviv Israel"},{"name":"Neonatology Tel Aviv Medical Centre Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Lavie","sequence":"additional","affiliation":[{"name":"Neonatology Carmel Medical Centre Haifa Israel"},{"name":"Rappaport Faculty of Medicine Technion \u2013 Israel Institute of Technology Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-5257","authenticated-orcid":false,"given":"Tatiana","family":"Smolkin","sequence":"additional","affiliation":[{"name":"The Azrieli Faculty of Medicine in the Galilee Bar\u2010Ilan University Safed Israel"},{"name":"Neonatology Baruch Padeh Medical Centre Poria Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Troitzky","sequence":"additional","affiliation":[{"name":"Neonatology Barzilai Medical Centre Ashkelon Israel"},{"name":"Ben\u2010Gurion University of the Negev Be'er Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-7326","authenticated-orcid":false,"given":"Michal","family":"Stein","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine Technion \u2013 Israel Institute of Technology Haifa Israel"},{"name":"Infectious disease and infection control unit Hillel Yaffe Medical Centre Hadera Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the EOS Israeli study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.11.046"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(12)70019-1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199407000-00008"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000091294.63706.f3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012657"},{"key":"e_1_2_10_7_1","first-page":"909","volume-title":"Nelson Textbook of Pediatrics","author":"Stoll BJ","year":"2016"},{"key":"e_1_2_10_8_1","first-page":"138","article-title":"Epidemiology of Invasive Early\u2010Onset Neonatal Sepsis, 2005 to 2014","volume":"2016","author":"Schrag SJ","year":"2005","journal-title":"Pediatrics"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0541"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200007203430310"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2171"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.027375-0"},{"key":"e_1_2_10_13_1","first-page":"DC24\u20107","article-title":"Isolation of MRSA, ESBL and AmpC \u2010 \u03b2 \u2010lactamases from neonatal sepsis at a tertiary care hospital","volume":"8","author":"Chelliah A","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-777X.154444"},{"key":"e_1_2_10_15_1","unstructured":"Israel Center for Disease Control \u2010 ICDC.Summary prevalence of early\u2010onset sepsis caused by group B Streptococcus in Israel 2010\u20132016. Israel Ministry of Health Publication 2017. Accessed on 24th of May 2019 athttps:\/\/www.health.gov.il\/PublicationsFiles\/GBS.pdf."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181acf6bd"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318223bad2"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2017-314671"},{"key":"e_1_2_10_19_1","first-page":"866","article-title":"Is there an increase in the incidence of gbs carrier rates among pregnant women in northern Israel?","volume":"145","author":"German L","year":"2006","journal-title":"Harefuah."},{"key":"e_1_2_10_20_1","first-page":"698","article-title":"Prevention of early\u2010onset neonatal group B streptococcal infection: is universal screening by culture universally applicable?","volume":"8","author":"Eisenberg VH","year":"2006","journal-title":"Isr Med Assoc J."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340801908759"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)00977-7"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piv013"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1546"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000337062"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-017-2975-z"},{"key":"e_1_2_10_27_1","first-page":"138","article-title":"Are the \u201cgood old\u201d antibiotics still appropriate for early\u2010onset neonatal sepsis? A 10 year survey","volume":"11","author":"Maayan\u2010Metzger A","year":"2009","journal-title":"Isr Med Assoc J."},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1552935"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.12.024"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu069"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.14889","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.14889","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.14889","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T03:38:38Z","timestamp":1694230718000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.14889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,4]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1111\/apa.14889"],"URL":"https:\/\/doi.org\/10.1111\/apa.14889","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"type":"print","value":"0803-5253"},{"type":"electronic","value":"1651-2227"}],"subject":[],"published":{"date-parts":[[2019,8,4]]},"assertion":[{"value":"2019-03-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}