Early-Onset Sepsis an NICHD/CDC Surveillance Study

NCT ID: NCT02410486

Last Updated: 2019-03-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

570 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-04-30

Study Completion Date

2017-12-31

Brief Summary

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This prospective surveillance study will be conducted over a 2 year period to determine current rates of Early-Onset Sepsis (EOS)/ Early-Onset Meningitis (EOM), associated pathogens, antimicrobial resistance, signs and symptoms and infant outcomes.

Detailed Description

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Neonatal pathogens other than group B Streptococcus (GBS) and resistant to beta-lactam antibiotics have emerged as the most common etiologic agents of EOS and EOM among preterm and term neonates and result in high mortality rates, potentially offsetting the decreased burden of early-onset GBS disease prevented by maternal intrapartum chemoprophylaxis.

Primary Outcomes of this study:

1. To determine current hospital-based rates of early-onset neonatal infection (total, GA-specific and BW-specific, and pathogen-specific) in term and preterm infants in the era of maternal intrapartum antibiotic prophylaxis to prevent vertical transmission of group B streptococcal disease. Early-onset infection comprises EOS and/or EOM and is defined as isolation of a pathogen from blood or cerebrospinal fluid (CSF) obtained within 72 hours of birth and provision of appropriate antibiotic treatment for 5 or more days (or \<5 days if death occurs while receiving antibiotic therapy).
2. To determine the antimicrobial susceptibility patterns of organisms associated with EOS and EOM

The case control aspect of this study will address 2 major conundrums regarding EOS: Can we identify risk factors for early-onset Gram-negative infections that might lead to intervention strategies to reduce risk and can we identify infants born to mothers with clinical chorioamnionitis who are at highest risk for early-onset sepsis and thus warrant antibiotic treatment soon after birth?

Conditions

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Infant, Newborn, Diseases Early Onset Neonatal Sepsis Early-Onset Meningitis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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EOS infant / mother with chorio

Infant with EOS (Gram-positive or Gram-negative) and mother with Chorioamnionitis

No interventions assigned to this group

EOS infant / mother without chorio

Infant with EOS (Gram-positive or Gram-negative) and mother without Chorioamnionitis

No interventions assigned to this group

EOS Gram-neg infant / mother with chorio

Infant with Gram-negative EOS and mother with Chorioamnionitis

No interventions assigned to this group

Gram-neg infant / mother without chorio

Infant with Gram-negative EOS and mother without Chorioamnionitis

No interventions assigned to this group

Gram-pos infant / mother with chorio

Infant with Gram-positive EOS and mother with Chorioamnionitis

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Case Surveillance: Live born infants with gestational age of at least 22 weeks and birth weight \>400 g and \<72 hours of age who are delivered at NRN hospitals and have early-onset sepsis and meningitis defined as isolation of a pathogen from blood or CSF obtained within 72 hours of birth and provision of appropriate antibiotic treatment for 5 or more days (or \<5 days if death occurs while receiving antibiotic therapy).
* Controls: Live born infants with gestational age of at least 22 weeks and birth weight \>400 g who are delivered at NRN hospitals and have not been evaluated for early-onset sepsis (\<72 hours of age) or if evaluated, they have sterile blood and/or CSF cultures and were not treated with prolonged antibiotics for clinical "culture negative" sepsis. Controls for infants with Gram-negative infection will be infants without early-onset infection. Controls for infants born to mothers with clinical chorioamnionitis will be infants without early-onset infection born to mothers with clinical chorioamnionitis. Control infants will be born at the same hospital as cases, with the same gestational age grouping as cases (22 0/7 - 28 6/7 weeks; 29 0/7 - 33 6/7 weeks; 34 0/7 - 36 6/7 weeks; and ≥ 37 weeks).

Exclusion Criteria

* Stillbirths and infants who die in the delivery room will be excluded.
* Infants who die within 12 hours of age will be excluded if they have not been evaluated for possible infection-ie, do not have a blood culture obtained to identify EOS.
Maximum Eligible Age

72 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centers for Disease Control and Prevention

FED

Sponsor Role collaborator

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

NICHD Neonatal Research Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Barbara Stoll, MD

Role: STUDY_DIRECTOR

The University of Texas Health Science Center, Houston

Michele Walsh, MD

Role: PRINCIPAL_INVESTIGATOR

Case Western Reserve University, Rainbow Babies and Children's Hospita

Seetha Shankaran, MD

Role: PRINCIPAL_INVESTIGATOR

Wayne State University

Abbot Laptook, MD

Role: PRINCIPAL_INVESTIGATOR

Brown University, Women & Infants Hospital of Rhode Island

Michael Cotten, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Greg Sokol, MD

Role: PRINCIPAL_INVESTIGATOR

Indiana University

Abhik Das, PhD

Role: PRINCIPAL_INVESTIGATOR

RTI International

Krisa Van Meurs, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Brenda Poindexter, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Medical Center, Cincinnati

Waldemar Carlo, MD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Kristi Watterberg, MD

Role: PRINCIPAL_INVESTIGATOR

University of New Mexico

Myra Wyckoff, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas, Southwestern Medical Center at Dallas

Kathleen Kennedy, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center, Houston

Barbara Schmidt, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Carl D'Angio, MD

Role: PRINCIPAL_INVESTIGATOR

University of Rochester

Pablo Sanchez, MD

Role: PRINCIPAL_INVESTIGATOR

Research Institute at Nationwide Children's Hospital

William Truog, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Mercy Hospital Kansas City

Uday Devaskar, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, Los Angeles

Bradley Yoder, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

University of California - Los Angeles

Los Angeles, California, United States

Site Status

Stanford University

Palo Alto, California, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

Wayne State University

Detroit, Michigan, United States

Site Status

Children's Mercy Hospital

Kansas City, Missouri, United States

Site Status

University of New Mexico

Albuquerque, New Mexico, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

RTI International

Durham, North Carolina, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Cincinnati Children's Medical Center

Cincinnati, Ohio, United States

Site Status

Case Western Reserve University

Cleveland, Ohio, United States

Site Status

Research Institute at Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Brown University, Women & Infants Hospital of Rhode Island

Providence, Rhode Island, United States

Site Status

University of Texas Southwestern Medical Center at Dallas

Dallas, Texas, United States

Site Status

University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Kilpatrick R, Greenberg R, Hansen NI, Shankaran S, Carlo WA, Cotten CM, Stoll BJ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study. J Perinatol. 2025 Jan;45(1):139-145. doi: 10.1038/s41372-024-02064-5. Epub 2024 Aug 5.

Reference Type DERIVED
PMID: 39103472 (View on PubMed)

Other Identifiers

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UG1HD034216

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD027904

Identifier Type: NIH

Identifier Source: secondary_id

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UG1HD021364

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD027853

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD040689

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD040492

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD027851

Identifier Type: NIH

Identifier Source: secondary_id

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UG1HD087229

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD027856

Identifier Type: NIH

Identifier Source: secondary_id

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UG1HD053109

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD068284

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD068278

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD068244

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD068263

Identifier Type: NIH

Identifier Source: secondary_id

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UG1HD027880

Identifier Type: NIH

Identifier Source: secondary_id

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UG1HD068270

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD053089

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD087226

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U10HD036790

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NICHD-NRN-0055

Identifier Type: -

Identifier Source: org_study_id

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