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Peer-reviewedCC BY-NC-ND 4.0Journal of Perinatology

Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship

  • Alessandra Guiterrez1
  • Imran Mir2
  • Katherine Stumpf2,3
  • Leslee M. Roberts2
  • Natasha W. Hanners4
  • L. Steven Brown3
  • Julide Sisman2
4 affiliations
  1. 1University of Texas Southwestern Medical School, Dallas, USA
  2. 2Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, USA
  3. 3Health System Research, Parkland Health and Hospital System, Dallas, TX USA
  4. 4Department of Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, USA
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Abstract

Objective: To identify risk factors for early-onset sepsis (EOS) in extremely preterm infants.

Study design: This retrospective study included 554 infants at 22–296/7 weeks’ gestation at Parkland Hospital Dallas, Texas, from 2018 to 2023. Proven EOS was defined by positive blood culture within 72 hours after birth; suspected EOS by ≥5 days of antibiotics despite negative cultures. Remaining infants served as controls. Maternal, neonatal, delivery, and placental characteristics were compared. Low EOS risk was defined as cesarean delivery without labor, rupture of membranes (ROM) at delivery, and no chorioamnionitis.

Results: Prelabor preterm ROM and acute chorioamnionitis on placental pathology were more common among the infants with EOS than those with suspected sepsis and controls (P = 0.02; OR 5.5, 95% CI 1.43–21, P = 0.01, respectively). None of the infants with proven EOS were classified as low risk.

Conclusion: Risk assessment for EOS should be promoted to enhance antibiotic stewardship.

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Cite

BibTeXRIS
BibTeX
@article{guiterrez2026risk,
  title = {{Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship}},
  author = {Alessandra Guiterrez and Imran Mir and Katherine Stumpf and Leslee M. Roberts and Natasha W. Hanners and L. Steven Brown and Julide Sisman},
  journal = {Journal of Perinatology},
  year = {2026},
  month = aug,
  doi = {10.1038/s41372-026-02879-4},
  url = {https://doi.org/10.1038/s41372-026-02879-4},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Risk assessment of early-onset sepsis in extremely preterm infants: implications for antibiotic stewardship
AU  - Alessandra Guiterrez
AU  - Imran Mir
AU  - Katherine Stumpf
AU  - Leslee M. Roberts
AU  - Natasha W. Hanners
AU  - L. Steven Brown
AU  - Julide Sisman
PY  - 2026
DA  - 2026/08/21
JO  - Journal of Perinatology
DO  - 10.1038/s41372-026-02879-4
UR  - https://doi.org/10.1038/s41372-026-02879-4
AB  - Objective: To identify risk factors for early-onset sepsis (EOS) in extremely preterm infants.  Study design: This retrospective study included 554 infants at 22–296/7 weeks’ gestation at Parkland Hospital Dallas, Texas, from 2018 to 2023. Proven EOS was defined by positive blood culture within 72 hours after birth; suspected EOS by ≥5 days of antibiotics despite negative cultures. Remaining infants served as controls. Maternal, neonatal, delivery, and placental characteristics were compared. Low EOS risk was defined as cesarean delivery without labor, rupture of membranes (ROM) at delivery, and no chorioamnionitis.  Results: Prelabor preterm ROM and acute chorioamnionitis on placental pathology were more common among the infants with EOS than those with suspected sepsis and controls (P = 0.02; OR 5.5, 95% CI 1.43–21, P = 0.01, respectively). None of the infants with proven EOS were classified as low risk.  Conclusion: Risk assessment for EOS should be promoted to enhance antibiotic stewardship.
SN  - 0743-8346
SN  - 1476-5543
ER  -