{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:15:38Z","timestamp":1783138538281,"version":"3.54.6"},"reference-count":27,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"London Operational Delivery Network","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,10]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We sought to compare the incidence of early-onset sepsis (EOS) in infants \u226534 weeks\u2019 gestation identified &gt;24\u2009hours after birth, in hospitals using the Kaiser Permanente Sepsis Risk Calculator (SRC) with hospitals using the National Institute for Health and Care Excellence (NICE) guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Prospective observational population-wide cohort study involving all 26 hospitals with neonatal units colocated with maternity services across London (10 using SRC, 16 using NICE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All live births \u226534 weeks\u2019 gestation between September 2020 and August 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>\n                      EOS was defined as isolation of\n                      <jats:italic>a bacterial pathogen in the blood or cerebrospinal fluid (CSF) culture from birth to 7 days of age<\/jats:italic>\n                      . We evaluated the incidence of EOS identified by culture obtained &gt;24\u2009hours to 7 days after birth. We also evaluated the rate empiric antibiotics were commenced &gt;24\u2009hours to 7 days after birth, for a duration of \u22655\u2009days, with negative blood or CSF cultures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 99\u2009683 live births, 42\u2009952 (43%) were born in SRC hospitals and 56\u2009731 (57%) in NICE hospitals. The overall incidence of EOS (&lt;72\u2009hours) was 0.64\/1000 live births. The incidence of EOS identified &gt;24\u2009hours was 2.3\/100 000 (n=1) for SRC vs 7.1\/100 000 (n=4) for NICE (OR 0.5, 95%\u2009CI (0.1 to 2.7)). This corresponded to (1\/20) 5% (SRC) vs (4\/45) 8.9% (NICE) of EOS cases (\u03c7=0.3, p=0.59). Empiric antibiotics were commenced &gt;24\u2009hours to 7 days after birth in 4.4\/1000 (n=187) for SRC vs 2.9\/1000 (n=158) for NICE (OR 1.5, 95%\u2009CI (1.2 to 1.9)). 3111 (7%) infants received antibiotics in the first 24 hours in SRC hospitals vs 8428 (15%) in NICE hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was no significant difference in the incidence of EOS identified &gt;24\u2009hours after birth between SRC and NICE hospitals. SRC use was associated with 50% fewer infants receiving antibiotics in the first 24 hours of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-072708","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T11:40:54Z","timestamp":1690458054000},"page":"e072708","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of diagnoses of early-onset sepsis associated with use of Sepsis Risk Calculator versus NICE CG149: a prospective, population-wide cohort study in London, UK, 2020\u20132021"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6286-0629","authenticated-orcid":false,"given":"Chinthika","family":"Piyasena","sequence":"first","affiliation":[{"name":"Evelina London Children\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorana","family":"Galu","sequence":"additional","affiliation":[{"name":"Homerton University Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devangi","family":"Thakkar","sequence":"additional","affiliation":[{"name":"The Hillingdon University Hospitals NHS Foundation Trust, Harrow, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Kingston Hospital NHS Foundation Trust, Kingston upon Thames, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Longley","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0503-9807","authenticated-orcid":false,"given":"Katie","family":"Evans","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Sweeney","sequence":"additional","affiliation":[{"name":"London Neonatal Operational Delivery Network, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles","family":"Kendall","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadija","family":"Ben-Sasi","sequence":"additional","affiliation":[{"name":"London North West University Healthcare NHS Trust, Harrow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Richards","sequence":"additional","affiliation":[{"name":"Neonatology, St George\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Harris","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenni","family":"Jagodzinski","sequence":"additional","affiliation":[{"name":"London Neonatal Operational Delivery Network, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-533X","authenticated-orcid":false,"given":"Alicia","family":"Demirjian","sequence":"additional","affiliation":[{"name":"Evelina London Children\u2019s Hospital, London, UK"},{"name":"United Kingdom Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Lamagni","sequence":"additional","affiliation":[{"name":"United Kingdom Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5104-085X","authenticated-orcid":false,"given":"Kirsty","family":"Le Doare","sequence":"additional","affiliation":[{"name":"Centre for Neonatal and Paediatric Infection, St George\u2019s University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7540-7433","authenticated-orcid":false,"given":"Paul T","family":"Heath","sequence":"additional","affiliation":[{"name":"Centre for Neonatal and Paediatric Infection, St George\u2019s University of London, London, 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