{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:40:35Z","timestamp":1794242435729,"version":"4.9.0"},"reference-count":30,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2018,3,1]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The epidemiology of early-onset neonatal sepsis (EONS) varies over time, and requires regular surveillance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To analyse data on EONS in Australia and New Zealand.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective analysis of data collected longitudinally from multiple neonatal units from 2002 to 2012.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 386\u2009423 live births, 454 infants had EONS. The incidence rate of EONS was 1.20 per 1000 live births in 2002 and 0.83 in 2012, decreasing by 4% per year (95%\u2009CI 1% to 7%, p=0.007). Group B streptococcus (GBS) (37%) and <jats:italic>Escherichia coli<\/jats:italic> (25%) were the most prevalent organisms. The early-onset GBS (EOGBS) incidence rate was 0.43\/1000 live births, with no evidence of change over time (p=0.3). Of EOGBS-infected babies, 62% were born at term compared with 8% with early-onset <jats:italic>E. coli<\/jats:italic> sepsis, p&lt;0.0001. The mortality of <jats:italic>E. coli<\/jats:italic> early-onset sepsis (EOS) (25%) was higher than GBS (11%), but this difference in mortality was no longer significant after adjusting for gestation and birth weight. Mortality from EOS fell significantly over the study period (17% per year, 95%\u2009CI 10 to 24, p&lt;0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GBS was the most common cause of early sepsis, but the incidence was lower than prior to the introduction of intrapartum antibiotic prophylaxis, and remained steady over time. The mortality of early-onset <jats:italic>E. coli<\/jats:italic> sepsis was significantly higher than GBS sepsis, but this may have been because almost all babies with <jats:italic>E. coli<\/jats:italic> were born preterm, rather than a difference in virulence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2017-314671","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T12:12:03Z","timestamp":1522152723000},"page":"F248-F252","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Early-onset neonatal infections in Australia and New Zealand, 2002\u20132012"],"prefix":"10.1136","volume":"104","author":[{"given":"Tarun","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Neonatology, Westmead Hospital, Westmead, New South Wales, Australia"},{"name":"Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth H","family":"Barnes","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Discipline of Child Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,27]]},"reference":[{"key":"2025090511182495000_104.3.F248.1","unstructured":"UNICEF. The neonatal period is the most vulnerable time for a child. UNICEF, Neonatal Mortality, 2016. https:\/\/data.unicef.org\/topic\/child-survival\/neonatal-mortality\/. (accessed 21 Aug 2017)."},{"key":"2025090511182495000_104.3.F248.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"2025090511182495000_104.3.F248.3","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.203"},{"key":"2025090511182495000_104.3.F248.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60560-1"},{"key":"2025090511182495000_104.3.F248.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70804-7"},{"key":"2025090511182495000_104.3.F248.6","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1097\/00006454-199906000-00009","article-title":"Australasian study group for neonatal infections. Intrapartum antibiotics and early onset neonatal sepsis caused by group B streptococcus and other organisms","volume":"18","author":"Isaacs","year":"1999","journal-title":"Pediatr Infect Dis J"},{"key":"2025090511182495000_104.3.F248.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000128782.20060.79"},{"key":"2025090511182495000_104.3.F248.8","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.066134"},{"key":"2025090511182495000_104.3.F248.9","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1097\/INF.0000000000001568","article-title":"Late-onset neonatal sepsis -A 10-year review from North Queensland, Australia","volume":"36","author":"Gowda","year":"2017","journal-title":"Pediatr Infect Dis J"},{"key":"2025090511182495000_104.3.F248.10","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-310905"},{"key":"2025090511182495000_104.3.F248.11","first-page":"69","article-title":"The prevention of early-onset neonatal group B streptococcus infection: New Zealand Consensus Guidelines 2014","volume":"128","author":"Darlow","year":"2015","journal-title":"N Z Med J"},{"key":"2025090511182495000_104.3.F248.12","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/ajo.12378","article-title":"Early-onset neonatal group B streptococcus sepsis following national risk-based prevention guidelines","volume":"56","author":"Darlow","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025090511182495000_104.3.F248.13","doi-asserted-by":"crossref","unstructured":"Isaacs D . Evidence-based neonatal infections. Oxford: Wiley Blackwell, 2014.","DOI":"10.1002\/9781118636657"},{"key":"2025090511182495000_104.3.F248.14","doi-asserted-by":"crossref","unstructured":"Ohlsson A , Shah VS . Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev 2014:CD007467.doi:10.1002\/14651858.CD007467.pub4","DOI":"10.1002\/14651858.CD007467.pub3"},{"key":"2025090511182495000_104.3.F248.15","unstructured":"Verani JR , McGee L , Schrag SJ , et al . Prevention of perinatal group B streptococcal disease - revised guidelines from CDC, Morbidity Mortality Weekly Report. 2010;59(RR-10):1\u201336."},{"key":"2025090511182495000_104.3.F248.16","unstructured":"Australian Bureau of Statistics. Births, Australia, 2012. Canberra: Government of Australia, 2013. http:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/Products\/3301.0~2012~Main+Features~Births?OpenDocument. (accessed 18 Feb 2018)."},{"key":"2025090511182495000_104.3.F248.17","unstructured":"New Zealand Government. Stats NZ. Births and deaths. NZ Government, 2016. https:\/\/www.stats.govt.nz\/topics\/births-and-deaths. (accessed 18 Feb 18)."},{"key":"2025090511182495000_104.3.F248.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61651-6"},{"key":"2025090511182495000_104.3.F248.19","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1111\/jpc.12830","article-title":"Group B streptococcal disease and genotypes in Australian infants","volume":"51","author":"Ko","year":"2015","journal-title":"J Paediatr Child Health"},{"key":"2025090511182495000_104.3.F248.20","unstructured":"RANZCOG. Maternal group B streptococcus in pregnancy: screening and treatment: college statement. Australia: the royal Australian and New Zealand college of obstetricians and gynaecologists. RANZCOG 2016."},{"key":"2025090511182495000_104.3.F248.21","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2011.40"},{"key":"2025090511182495000_104.3.F248.22","doi-asserted-by":"publisher","DOI":"10.1080\/10647440300025525"},{"key":"2025090511182495000_104.3.F248.23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2217"},{"key":"2025090511182495000_104.3.F248.24","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2013"},{"key":"2025090511182495000_104.3.F248.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(12)70019-1"},{"key":"2025090511182495000_104.3.F248.26","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.139865"},{"key":"2025090511182495000_104.3.F248.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2011.02.001"},{"key":"2025090511182495000_104.3.F248.28","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-300097"},{"key":"2025090511182495000_104.3.F248.29","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2012-301767"},{"key":"2025090511182495000_104.3.F248.30","doi-asserted-by":"crossref","unstructured":"Williams P , Berkley J , Isaacs D . Antimicrobial resistance among children in Sub-Saharan Africa. Lancet Infectious Diseases 2017, 2017. http:\/\/dx.doi.org\/10.1016\/S1473-3099(17)30467-X.","DOI":"10.1016\/S1473-3099(17)30467-X"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2017-314671","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:42:46Z","timestamp":1757097766000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/archdischild-2017-314671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,27]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,4,29]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1136\/archdischild-2017-314671"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2017-314671","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,27]]}}}