Screening for early-onset neonatal sepsis on the Kaiser Permanente sepsis risk calculator could reduce neonatal antibiotic usage by two-thirds  

作　　者：Michelle Fernandes Lucinda Winckworth Lyrille Lee Madiha Akram Simon Struthers 

机构地区：[1]The Department of Neonatal Medicine and the Neonatal Intensive Care Unit,Princess Anne Hospital,University Hospitals Southampton NHS Foundation Trust,Southampton,UK [2]The MRC Lifecourse Epidemiology Centre and Human Development and Health Academic Unit,Faculty of Medicine,University of Southampton,Southampton,UK [3]Nuffield Department of Women’s and Reproductive Health,John Radcliffe Hospital,University of Oxford,Oxford,UK [4]Department of Pediatrics,Royal Hampshire County Hospital,Winchester,UK

出　　处：《Pediatric Investigation》2022年第3期171-178,共8页儿科学研究（英文）

摘　　要：Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,UK.SRC projections were obtained using its virtual risk estimator.Results:Sixty infants received PAb within the first 72 h of birth during the study period.Of these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven sepsis.Based on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>3.Birth below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>3.Interpretation:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.

关 键 词：Early onset neonatal sepsis Kaiser Permanente sepsis risk calculator NICE guidelines Parenteral antibiotics 

分 类 号：R722.131[医药卫生—儿科]