Use of a Modified Early-Onset Sepsis Risk Calculator for Neonates Exposed to Chorioamnionitis
| Autor: | Zubair H. Aghai, Caroline Edwards, David Carola, Cassandra Coleman, Jay S. Greenspan, Amy J. Sloane, Margaret A. Lafferty |
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| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty Chorioamnionitis Risk Assessment Sepsis 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Humans Blood culture 030212 general & internal medicine Retrospective Studies medicine.diagnostic_test Obstetrics business.industry Incidence Incidence (epidemiology) Infant Newborn Retrospective cohort study medicine.disease Anti-Bacterial Agents Bacteremia Pediatrics Perinatology and Child Health Cohort Female Neonatal Sepsis business |
| Zdroj: | The Journal of Pediatrics. 213:52-57 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2019.04.062 |
| Popis: | Objective To validate the recently modified Kaiser Permanente early-onset sepsis (EOS) calculator with a higher baseline incidence in chorioamnionitis exposed neonates. Study design This is a retrospective study of chorioamnionitis-exposed neonates born at ≥35 weeks of gestation with a known EOS incidence of 4.3/1000. The risk and management categories were calculated using the calculator with an incidence of 4/1000. The results were compared with a previous analysis of the same cohort that used an EOS incidence of 0.5/1000. Results In our sample, the EOS calculator recommends at least a blood culture in 834 of 896 (93.1%) and empiric antibiotics in 533 of 896 (59.5%) chorioamnionitis-exposed neonates when using an EOS incidence of 4/1000. This captures 5 of 5 neonates (100%) with EOS. When using a baseline EOS incidence of 0.5/1000, the calculator recommends at least a blood culture in only 289 of 896 (32.2%) and empiric antibiotics in only 209 of 896 (23.3%) neonates, but fails to recommend empiric antibiotics in 2 of 5 neonates with EOS (40%). Conclusions When using an EOS risk of 4 of 1000 in infants exposed to mothers with chorioamnionitis, the EOS calculator has the ability to capture an increased number of neonates with culture-positive EOS. However, this change also leads to nearly a 3-fold increase in the use of empiric antibiotics and an evaluation with blood culture in almost all infants born to mothers with chorioamnionitis. |
| Databáze: | OpenAIRE |
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