Early onset sepsis in late preterm and term infants - can risk stratification be improved with serial 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. At Monash Newborn, the EOS Calculator was introduced to better stratify risk in the late preterm or term infants some years ago. This tool has been shown to be effective in promoting antimicrobial stewardship (i.e. to reduce antibiotic use) safely. The aims of this project are: 1) To investigate the prevalence of EOS in infants >34 weeks gestation at Monash Health sites with the use of the EOS calculator, antibiotic use and true sepsis rates. 2) To investigate if clinical and blood markers in maternal and infant records can contribute to EOS detection. Methods: To utilise Monash Health EMR in order to obtain a large dataset which will be analyse using statistical methodology or advanced analytics in order achieve the aims of the project.