Acta paediatrica (Oslo, Norway : 1992) · 2026
Incidence of Culture-Proven Neonatal Sepsis and Its Correlation With Nurse Staffing in a Level IV Neonatal Intensive Care Unit: A Six-Year Cohort Study.
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Gudiksen A, Breindahl M, Hertz F B, Knudsen J D, Beck S A, Herrmann S G, Aunsholt L, Carlsen E M
Аннотация
AIM: To assess the incidence of culture-proven sepsis and examine the correlation between positive blood cultures and nurse staffing in a Level IV neonatal intensive care unit (NICU).
METHODS: This retrospective cohort study included neonates with ≥ 1 positive blood culture and signs of infection between 2018 and 2023. Infection episodes were defined as culture-proven sepsis treated with antibiotics for ≥ 3 days and divided into early-onset sepsis (EOS), ≤ 72 h after birth or late-onset sepsis (LOS), > 72 h after birth. Nurse staffing was prospectively recorded and expressed as the ratio of actual to recommended attendance according to British Association of Perinatal Medicine standards.
RESULTS: Among 6 856 admissions, 514 episodes of positive blood cultures were identified in 310 neonates; 421 (82%) were classified as infections. Coagulase-negative staphylococci were the predominant pathogen. The incidence of positive blood cultures increased from 5.4% in 2018-2020 to 6.9% in 2021-2023. EOS increased (from 0.6% to 1.1%, p = 0.02). There was an inverse correlation between nurse staffing levels and number of LOS episodes (p < 0.01).
CONCLUSION: Culture-proven sepsis increased over time in this NICU, primarily driven by EOS. Higher numbers of LOS episodes correlated with lower nurse staffing levels, suggesting a potential role of adequate staffing in infection prevention.
METHODS: This retrospective cohort study included neonates with ≥ 1 positive blood culture and signs of infection between 2018 and 2023. Infection episodes were defined as culture-proven sepsis treated with antibiotics for ≥ 3 days and divided into early-onset sepsis (EOS), ≤ 72 h after birth or late-onset sepsis (LOS), > 72 h after birth. Nurse staffing was prospectively recorded and expressed as the ratio of actual to recommended attendance according to British Association of Perinatal Medicine standards.
RESULTS: Among 6 856 admissions, 514 episodes of positive blood cultures were identified in 310 neonates; 421 (82%) were classified as infections. Coagulase-negative staphylococci were the predominant pathogen. The incidence of positive blood cultures increased from 5.4% in 2018-2020 to 6.9% in 2021-2023. EOS increased (from 0.6% to 1.1%, p = 0.02). There was an inverse correlation between nurse staffing levels and number of LOS episodes (p < 0.01).
CONCLUSION: Culture-proven sepsis increased over time in this NICU, primarily driven by EOS. Higher numbers of LOS episodes correlated with lower nurse staffing levels, suggesting a potential role of adequate staffing in infection prevention.