{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:42:02Z","timestamp":1785404522195,"version":"3.56.0"},"reference-count":60,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Thai Neonatal Society"},{"DOI":"10.13039\/501100004508","name":"Prince of Songkla University","doi-asserted-by":"publisher","award":["REC. 69\u2013209\u20131\u20131"],"award-info":[{"award-number":["REC. 69\u2013209\u20131\u20131"]}],"id":[{"id":"10.13039\/501100004508","id-type":"DOI","asserted-by":"publisher"}]},{"award":["REC. 69\u2013209\u20131\u20131"],"award-info":[{"award-number":["REC. 69\u2013209\u20131\u20131"]}],"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objective: To determine the incidence, causative pathogens, risk factors, and clinical outcomes of early-onset sepsis (EOS) in very preterm (gestational age &lt; 32 weeks) and very low birth weight (birth weight &lt; 1500 g) neonates. Methods: This retrospective study analyzed data from the Thai Neonatal Network registry (2019\u20132024; total 22 neonatal units). EOS was defined as bacteremia or bacterial meningitis within 72 h of birth. Results: Among 792 neonates (median [interquartile range] gestational age, 28 [26\u201329] weeks; median [interquartile range] birth weight, 960 [779\u20131190] g), the incidence of EOS was 4.0% (n = 32). Predominant pathogens were Escherichia coli (n = 10) and Acinetobacter baumannii (n = 9). Antibiograms showed high non-susceptibility for E. coli and A. baumannii to gentamicin (44.4% and 83.3%, respectively) and cefotaxime (37.5% and 75.0%, respectively). Although E. coli remained susceptible to amikacin and meropenem (100%), A. baumannii exhibited extensive resistance (66.7% and 83.3%, respectively). Multivariable analysis identified chorioamnionitis (adjusted odds ratio [aOR] 1.12; 95% confidence interval [CI]: 1.07\u20131.18) and 5 min Apgar score &lt; 7 (aOR 1.05; 95% CI: 1.02\u20131.18) as significant risk factors. EOS was independently associated with increased early neonatal mortality within 7 days of life (aOR, 1.26; 95% CI: 1.16\u20131.36). Conclusions: The incidence of EOS is high among very preterm infants in Thailand and significantly increases mortality rates. The prevalence of multidrug-resistant A. baumannii in neonatal EOS is a critical concern that limits the efficacy of empirical treatments. These findings highlight the urgent need for targeted interventions and enhanced antimicrobial stewardship to improve neonatal survival rates.<\/jats:p>","DOI":"10.3390\/antibiotics15070674","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:55:32Z","timestamp":1783598132000},"page":"674","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors and Outcomes of Early-Onset Sepsis in Very Preterm Infants: Results from the Thai Neonatal Registry (ThaiNy)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0670-4442","authenticated-orcid":false,"given":"Junya","family":"Jirapradittha","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3012-9601","authenticated-orcid":false,"given":"Dissajee","family":"Lumbiganon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Navamindradhiraj University, Bangkok 10300, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2363-6362","authenticated-orcid":false,"given":"Anucha","family":"Thatrimontrichai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buranee","family":"Swatesutipun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6785-3196","authenticated-orcid":false,"given":"Kanmalee","family":"Jenjarat","sequence":"additional","affiliation":[{"name":"Nakornping Hospital, Chiang Mai 50180, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kullapat","family":"Srisomsap","sequence":"additional","affiliation":[{"name":"Police General Hospital, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6979-588X","authenticated-orcid":false,"given":"Mananya","family":"Sukthong","sequence":"additional","affiliation":[{"name":"Buddhachinaraj Phitsanulok Hospital, Phitsanulok 65000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manunya","family":"Apiwattanaporn","sequence":"additional","affiliation":[{"name":"Udonthani Hospital, Udon Thani 41000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napas","family":"Sripirom","sequence":"additional","affiliation":[{"name":"Bhumibol Adulyadej Hospital, Bangkok 10220, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawamon","family":"Soontaravarapas","sequence":"additional","affiliation":[{"name":"Lampang Hospital, Lampang 52000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichanan","family":"Sahakaro","sequence":"additional","affiliation":[{"name":"Nopparat Rajathanee Hospital, Bangkok 10230, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ploypailin","family":"Preechawetchakul","sequence":"additional","affiliation":[{"name":"Hatyai Hospital, Songkhla 90110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornpimon","family":"Janyoungsak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok 26120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornpimon","family":"Rojanakarin","sequence":"additional","affiliation":[{"name":"Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-9090","authenticated-orcid":false,"given":"Shanika","family":"Kosarat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarat","family":"Sirichaipornsak","sequence":"additional","affiliation":[{"name":"Sakon Nakhon Hospital, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudatip","family":"Kositamongkol","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6950-232X","authenticated-orcid":false,"given":"Suparat","family":"Tipprasert","sequence":"additional","affiliation":[{"name":"Roi Et Hospital, Roi Et 45000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6676-6272","authenticated-orcid":false,"given":"Tanin","family":"Pirunnet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaninee","family":"Chitsinchayakul","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaiporn","family":"Bowornkitiwong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatchay","family":"Prempunpong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Andersen, M., Rohde, G.B., Nielsen, S.Y., Murra, M., Klingenberg, C., Matthiesen, N.B., and Henriksen, T.B. (Arch. Dis. Child. Fetal Neonatal Ed., 2026). Early-onset neonatal infection and cognitive impairment: A nationwide cohort study, Arch. Dis. Child. Fetal Neonatal Ed., in press.","DOI":"10.1136\/archdischild-2025-329965"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ortgies, T., Rullmann, M., Ziegelh\u00f6fer, D., Bl\u00e4ser, A., and Thome, U.H. (2021). The role of early-onset-sepsis in the neurodevelopment of very low birth weight infants. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-02738-5"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"F249","DOI":"10.1136\/archdischild-2012-301767","article-title":"Neonatal infections in China, Malaysia, Hong Kong and Thailand","volume":"98","author":"Hammoud","year":"2013","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/INF.0000000000003380","article-title":"Antimicrobial susceptibility profiles among neonatal early-onset sepsis pathogens","volume":"41","author":"Flannery","year":"2022","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"813","DOI":"10.3233\/NPM-210978","article-title":"Perinatal bacterial colonization and neonatal early-onset sepsis: A case-control study","volume":"15","author":"Foo","year":"2022","journal-title":"J. Neonatal Perinat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e20162013","DOI":"10.1542\/peds.2016-2013","article-title":"Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014","volume":"138","author":"Schrag","year":"2016","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"F144","DOI":"10.1136\/adc.2008.139865","article-title":"Neonatal infections in Asia","volume":"94","author":"Tiskumara","year":"2009","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Vatne, A., Klingenberg, C., Rettedal, S., and \u00d8ymar, K. (2021). Early-onset sepsis in neonates\u2014A population-based study in South-West Norway from 1996 to 2018. Front. Pediatr., 9.","DOI":"10.3389\/fped.2021.634798"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1097\/INF.0000000000004022","article-title":"Epidemiologic changes of neonatal early-onset sepsis after the implementation of universal maternal screening for Group B Streptococcus in Hong Kong","volume":"42","author":"Wang","year":"2023","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"van der Weijden, B.M., van Dorth, J.R., Achten, N.B., and Pl\u00f6tz, F.B. (2024). Factors associated with prolonged antibiotic therapy in neonates with suspected early-onset sepsis. Antibiotics, 13.","DOI":"10.3390\/antibiotics13050388"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115031","DOI":"10.1016\/j.jpeds.2026.115031","article-title":"Neonatal sepsis from 2014 to 2024: The resurgence of gram-negative rods","volume":"293","author":"Fleiss","year":"2026","journal-title":"J. Pediatr."},{"key":"ref_12","first-page":"1063","article-title":"Neonatal group B Streptococcus sepsis: A multicenter study in Thailand","volume":"48","author":"Thatrimontrichai","year":"2017","journal-title":"Southeast. Asian J. Trop. Med. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0140-6736(11)61651-6","article-title":"Group B Streptococcal disease in infants aged younger than 3 months: Systematic review and meta-analysis","volume":"379","author":"Edmond","year":"2012","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1017\/ice.2018.58","article-title":"A systematic review of the burden of multidrug-resistant healthcare-associated infections among intensive care unit patients in southeast asia: The rise of multidrug-resistant acinetobacter baumannii","volume":"39","author":"Teerawattanapong","year":"2018","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/INF.0000000000003231","article-title":"Risk factors associated with 30-day mortality among neonates with A. baumannii sepsis","volume":"40","author":"Thatrimontrichai","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/INF.0b013e31827c97ba","article-title":"Carbapenem-resistant Acinetobacter baumannii bacteremia in neonates","volume":"32","author":"Nakwan","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"(2016). Investigators of the Delhi Neonatal Infection Study (DeNIS) Collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: A cohort study. Lancet Glob. Health, 4, e752\u2013e760.","DOI":"10.1016\/S2214-109X(16)30148-6"},{"key":"ref_18","first-page":"438","article-title":"Trend and cut-off point of neonatal meningitis onset in a highly multidrug-resistant area","volume":"49","author":"Thatrimontrichai","year":"2018","journal-title":"Southeast. Asian J. Trop. Med. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jiac.2016.03.013","article-title":"Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study","volume":"22","author":"Thatrimontrichai","year":"2016","journal-title":"J. Infect. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1007\/s00431-011-1478-6","article-title":"Can intravenous colistin effectively treat ventilator-associated pneumonia in the pediatric and neonatal patients?","volume":"170","author":"Nakwan","year":"2011","journal-title":"Eur. J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Thatrimontrichai, A., Pakhathirathien, P., Praditaukrit, M., Maneenil, G., and Dissaneevate, S. (2025). Non-susceptibility of early-onset sepsis pathogens to the combination of ampicillin and gentamicin among neonates in Thailand. Antibiotics, 14.","DOI":"10.3390\/antibiotics14050519"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.pedneo.2012.06.003","article-title":"Prevalence and pathogen distribution of neonatal sepsis among very-low-birth-weight infants","volume":"53","author":"Lim","year":"2012","journal-title":"Pediatr. Neonatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S1875-9572(09)60042-5","article-title":"Neonatal sepsis: A 6-year analysis in a neonatal care unit in Taiwan","volume":"50","author":"Wu","year":"2009","journal-title":"Pediatr. Neonatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"144","DOI":"10.11622\/smedj.2016056","article-title":"Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units","volume":"57","author":"Boo","year":"2016","journal-title":"Singap. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e736","DOI":"10.1542\/peds.2009-2017","article-title":"Outcome of early-onset sepsis in a national cohort of very low birth weight infants","volume":"125","author":"Klinger","year":"2010","journal-title":"Pediatrics"},{"key":"ref_26","doi-asserted-by":"crossref","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 Korea","volume":"30","author":"Lee","year":"2015","journal-title":"J. Korean Med. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Song, Y.H., Lee, J.A., Choi, B.M., and Lim, J.W. (2021). Risk factors and prognosis in very low birth weight infants treated for hypotension during the first postnatal week from the Korean Neonatal Network. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258328"},{"key":"ref_28","first-page":"684","article-title":"A clinical analysis of sepsis in very low birth weight infants","volume":"23","author":"Hu","year":"2021","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Salsabila, K., Toha, N.M.A., Rundjan, L., Pattanittum, P., Sirikarn, P., Rohsiswatmo, R., Wandita, S., Hakimi, M., Lumbiganon, P., and Green, S. (2022). Early-onset neonatal sepsis and antibiotic use in Indonesia: A descriptive, cross-sectional study. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13343-1"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e20182896","DOI":"10.1542\/peds.2018-2896","article-title":"Management of neonates born at \u226434 6\/7 weeks\u2019 gestation with suspected or proven early-onset bacterial sepsis","volume":"142","author":"Puopolo","year":"2018","journal-title":"Pediatrics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/INF.0000000000001473","article-title":"Clinical and microbiologic characteristics of early-onset sepsis among very low birth weight infants: Opportunities for antibiotic stewardship","volume":"36","author":"Mukhopadhyay","year":"2017","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e200593","DOI":"10.1001\/jamapediatrics.2020.0593","article-title":"Early-onset neonatal sepsis 2015 to 2017, the rise of Escherichia coli, and the need for novel prevention strategies","volume":"174","author":"Stoll","year":"2020","journal-title":"JAMA Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1097\/INF.0000000000002492","article-title":"Early-onset sepsis among preterm neonates in china, 2015 to 2018","volume":"38","author":"Jiang","year":"2019","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_34","unstructured":"The Centers for Disease Control and Prevention (CDC), and National Healthcare Safety Network (NHSN) (2025, January 31). Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and Non-Central Line Associated Bloodstream Infection), Available online: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/4psc_clabscurrent.pdf."},{"key":"ref_35","first-page":"12939","article-title":"Analysis of pathogens, drug resistance, sensitive antibiotic treatment and risk factors of early-onset sepsis in very low birth weight infants","volume":"13","author":"Yu","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1097\/INF.0000000000000175","article-title":"The role of coagulase-negative staphylococci in early onset sepsis in a large European cohort of very low birth weight infants","volume":"33","author":"Mularoni","year":"2014","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/INF.0b013e3182567b74","article-title":"Early-onset infections of very-low-birth-weight infants in Polish neonatal intensive care units","volume":"31","author":"Gadzinowski","year":"2012","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/jpc.12863","article-title":"Outcome comparison of very preterm infants cared for in the neonatal intensive care units in Australia and New Zealand and in Canada","volume":"51","author":"Hossain","year":"2015","journal-title":"J. Paediatr. Child Health"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Wang, W., Wang, Z., Wang, L., Li, S., Liu, J., Huang, Y., Liu, J., Zhu, C., Zhang, J., and Li, C. (2025). Early-onset neonatal sepsis in a Chinese maternal and child healthcare centre, 2017\u20132023. Front. Pediatr., 13.","DOI":"10.3389\/fped.2025.1521908"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1097\/INF.0000000000002976","article-title":"Epidemiology of early and late onset neonatal sepsis in very low birthweight infants: Data from the German Neonatal Network","volume":"40","author":"Haug","year":"2021","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Berardi, A., Zinani, I., Rossi, C., Spaggiari, E., D\u2019Amico, V., Toni, G., Bedetti, L., Lucaccioni, L., Iughetti, L., and Lugli, L. (2021). Antibiotic use in very low birth weight neonates after an antimicrobial stewardship program. Antibiotics, 10.","DOI":"10.3390\/antibiotics10040411"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S0022-3476(96)70192-0","article-title":"Early-onset sepsis in very low birth weight neonates: A report from the National Institute of Child Health and Human Development Neonatal Research Network","volume":"129","author":"Stoll","year":"1996","journal-title":"J. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1056\/NEJMoa012657","article-title":"Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants","volume":"347","author":"Stoll","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/01.inf.0000168749.82105.64","article-title":"Very low birth weight preterm infants with early onset neonatal sepsis: The predominance of gram-negative infections continues in the National Institute of Child Health and Human Development Neonatal Research Network, 2002\u20132003","volume":"24","author":"Stoll","year":"2005","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e2021052456","DOI":"10.1542\/peds.2021-052456","article-title":"Early-onset sepsis among very preterm infants","volume":"148","author":"Flannery","year":"2021","journal-title":"Pediatrics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1016\/S0378-3782(12)70019-1","article-title":"Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units","volume":"88","author":"Hornik","year":"2012","journal-title":"Early Hum. Dev."},{"key":"ref_47","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease: A public health perspective","volume":"45","author":"Verani","year":"1996","journal-title":"MMWR Recomm. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"389","DOI":"10.18203\/2349-3291.ijcp20180480","article-title":"Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates","volume":"5","author":"Shukla","year":"2018","journal-title":"Int. J. Contemp. Pediatr."},{"key":"ref_49","first-page":"7","article-title":"Clinico-bacteriological study of sepsis in VLBW neonates in tertiary care NICU in central india: A descriptive observational study","volume":"12","author":"Kadam","year":"2024","journal-title":"Indian J. Neonatal Med. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2259049","DOI":"10.1080\/14767058.2023.2259049","article-title":"Perinatal risk factors for neonatal early-onset sepsis: A meta-analysis of observational studies","volume":"36","author":"Guo","year":"2023","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1055\/a-2016-7568","article-title":"Risk factors for mortality or major morbidities of very preterm infants: A study from Thailand","volume":"41","author":"Thatrimontrichai","year":"2024","journal-title":"Am. J. Perinatol."},{"key":"ref_52","unstructured":"(2026, February 28). Vermont Oxford Trials Network Database Project. 2026 Manual of Operations, Part 2, Release 30.0. Available online: https:\/\/vtoxford.zendesk.com\/hc\/en-us\/article_attachments\/46018371439891."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"311","DOI":"10.31584\/jhsmr.2018.36.4.21","article-title":"Antimicrobial resistance: Genetic perspectives and implications","volume":"36","author":"Chusri","year":"2018","journal-title":"J. Health Sci. Med. Res."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Committee on Fetus Newborn, Barfield, W.D., Papile, L.-A., Baley, J.E., Benitz, W., Cummings, J., Carlo, W.A., Kumar, P., Polin, R.A., and Tan, R.C. (2012). Levels of neonatal care. Pediatrics, 130, 587\u2013597.","DOI":"10.1542\/peds.2012-1999"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1542\/peds.2012-0541","article-title":"Management of neonates with suspected or proven early-onset bacterial sepsis","volume":"129","author":"Polin","year":"2012","journal-title":"Pediatrics"},{"key":"ref_56","unstructured":"The Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) (2025, January 31). Pneumonia (Ventilator-Associated [VAP] and Non-Ventilator-Associated Pneumonia [PNEU]) Event, Available online: http:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/6pscvapcurrent.pdf."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0031-3955(16)34975-6","article-title":"Necrotizing enterocolitis: Treatment based on staging criteria","volume":"33","author":"Walsh","year":"1986","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"Jobe","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_59","unstructured":"R Core Team (2025, July 03). R-4.5.1 for Windows. Available online: https:\/\/cran.r-project.org\/bin\/windows\/base\/."},{"key":"ref_60","unstructured":"Chongsuvivatwong, V. (2025, July 03). Epicalc: Epidemiological Calculator. 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