Early onset sepsis in premature infants - investigating the diagnostic utility of clinical and laboratory markers

Early onset sepsis (EOS) is defined as that which occurs within the first 48 hours of life in newborn infants. EOS can be devastating; increasing mortality and often leaving the survivors with life-long sequalae. Due to this, zero-risk approach to early antibiotic therapy were used (antibiotic therapy in symptomatic or presence of risk factors in asymptomatic patients); and whilst effective, this strategy led to increased antibiotic use in those infants without sepsis. The EOS Calculator was introduced to better stratify risk in the late preterm or term infants some years ago. However, no current risk predictive tool for very preterm infants are available. Risk factors approach may help to antimicrobial stewardship (reducing empirical antibiotic use) - however, predictive utility could be improved. The aim of this project is to utilise the dataset from Monash Health's EMR (maternal and infant) including serial clinical and laboratory measurements in order to study whether this approach may improve the detection of EOS in very preterm infants.