Potential benefit from the implementation of the Kaiser Permanente neonatal early-onset sepsis calculator on clinical management of neonates with presumed sepsis

2021 ◽  
Author(s):  
Ioannis Kopsidas ◽  
Nafsika-Maria Molocha ◽  
Eleni Kourkouni ◽  
Susan Coffin ◽  
Despoina Gkentzi ◽  
...  
Keyword(s):  
Clinical Management ◽  
Early Onset ◽  
Potential Benefit ◽  
Kaiser Permanente ◽  
Early Onset Sepsis ◽  
Sepsis Calculator

scholarly journals Sensitivity of the Kaiser Permanente early-onset sepsis calculator: A systematic review and meta-analysis

2020 ◽  
Vol 19 ◽  
pp. 100227 ◽  
Author(s):  
Katherine J. Pettinger ◽  
Katie Mayers ◽  
Liz McKechnie ◽  
Bob Phillips
Keyword(s):  
Systematic Review ◽  
Early Onset ◽  
Meta Analysis ◽  
Kaiser Permanente ◽  
Early Onset Sepsis ◽  
Sepsis Calculator

Acute Funisitis Correlates With the Risk of Early-Onset Sepsis in Term Newborns Assessed Using the Kaiser Sepsis Calculator

2019 ◽  
Vol 22 (6) ◽  
pp. 523-531 ◽  
Author(s):  
Hongxiu Ji ◽  
Margie Bridges ◽  
Elizabeth Pesek ◽  
Kristin Graham ◽  
Lennart Tan ◽  
...  
Keyword(s):  
Risk Score ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Kaiser Permanente ◽  
Term Neonates ◽  
Early Onset Sepsis ◽  
Increased Risk ◽  
Sepsis Risk ◽  
Term Newborns ◽  
Sepsis Calculator

Background The risk of neonatal early-onset sepsis (EOS) is traditionally assessed on maternal signs of clinical chorioamnionitis. Recently, an online EOS risk calculator was developed by Kaiser Permanente using maternal and neonatal clinical parameters. We were interested in whether an increased Kaiser sepsis risk score correlates with histologic acute chorioamnionitis or acute funisitis. Design Included in this retrospective review are 119 chorioamnionitis-exposed term neonates from January 1, 2015 and December 31, 2016. Clinical charts from mother–baby pairs were reviewed. An EOS risk score was obtained using the online Kaiser Sepsis Calculator. The presence and severity of acute chorioamnionitis and acute funisitis were recorded. A SPSS software was used for statistical analysis (IBM, New Jersey, USA). Results The Kaiser Sepsis Calculator could identify 97 of 119 (81.5%) neonates without increased risk for sepsis. Histologic acute chorioamnionitis was present in 100 of 119 cases (84%), in which 44 cases (44%) show severe acute chorioamnionitis. Acute funisitis was recognized in 87 of 119 (73.1%) cases, all of which had concurrent acute chorioamnionitis. Severe funisitis was seen in 38 of the 87 cases (43.7%). The Kaiser Sepsis risk score correlates with the presence and severity of acute funisitis ( P = .037 and P = .044, respectively) but not with the presence or the severity of acute chorioamnionitis ( P = .105 and P = .672, respectively). Conclusion Our study provides histological evidence to support that the Kaiser Sepsis Calculator may help to effectively reduce unwarranted blood culture, antibiotics exposure, and neonatal intensive care unit admission in term neonates.

A comparison between risk-factor guidance for neonatal early-onset sepsis and Kaiser Permanente sepsis risk calculator in a Greek cohort

2021 ◽  
Vol 155 ◽  
pp. 105331
Author(s):  
Dimitrios Rallis ◽  
Foteini Balomenou ◽  
Konstantina Karantanou ◽  
Kleio Kappatou ◽  
Meropi Tzoufi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Early Onset ◽  
Risk Calculator ◽  
Kaiser Permanente ◽  
Early Onset Sepsis ◽  
Sepsis Risk

Neonatal Early-Onset Sepsis Calculator and Antibiotic Therapy—Reply

2020 ◽  
Vol 174 (5) ◽  
pp. 508
Author(s):  
Niek B. Achten ◽  
Claus Klingenberg ◽  
Frans B. Plötz
Keyword(s):  
Antibiotic Therapy ◽  
Early Onset ◽  
Early Onset Sepsis ◽  
Sepsis Calculator

scholarly journals Early-Onset Sepsis Risk Calculator: A Review Of Its Effectiveness And Comparative Study With Our Evidence-Based Local Guidelines

2021 ◽  
Author(s):  
Gianluigi Laccetta ◽  
Massimiliano Ciantelli ◽  
Cristina Tuoni ◽  
Emilio Sigali ◽  
Mario Miccoli ◽  
...  
Keyword(s):  
Gestational Age ◽  
Early Onset ◽  
Clinical Signs ◽  
Risk Calculator ◽  
Live Births ◽  
Early Onset Sepsis ◽  
Number Of Patients ◽  
Sepsis Risk ◽  
Empirical Antibiotics ◽  
Sepsis Calculator

Abstract Background According to most early-onset sepsis management guidelines, approximately 10% of the total neonatal population are exposed to antibiotics in the first postnatal days with subsequent increase of neonatal and pediatric comorbidities. Early-onset sepsis risk calculator has been developed with the purpose of avoiding antibiotic overtreatment among neonates ≥ 34 weeks’ gestational age: a review of literature demonstrates its effectiveness in reducing antibiotic overtreatment, laboratory testing, painful procedures and NICU admission; however, some missed cases of culture-positive early-onset sepsis have also been described. Methods All neonates with birth weight ≤ 1500 g, 34–36 weeks’ gestational age neonates with suspected intraamniotic infection and neonates with three clinical signs of early-onset sepsis or two signs and one risk factor for early-onset sepsis receive empirical antibiotics. Neonates ≥ 34 weeks’ gestational age with risk factors for early-onset sepsis or with one clinical indicator of early-onset sepsis undergo serial measurements of C-reactive protein and procalcitonin in the first 48–72 hours of life; they receive empirical antibiotics in case of abnormalities at blood exams with one or more clinical signs of early-onset sepsis. We therefore compared the number of patients for which antibiotics were needed, based on early-onset sepsis calculator, and the number of patients we treated with antibiotics during the study period. Comparisons between the groups were performed using McNemar’s test and statistical significance was set at p < 0.05. Results During the study period (1st January 2018-31st December 2018) 32/265 (12.1%) neonates ≥ 34 weeks’ gestational age at risk for early-onset sepsis received antibiotics within the first 12 hours of life. According to early-onset sepsis calculator: 55/265 (20.7%) patients would have received antibiotics with early-onset sepsis incidence 2/1000 live births (p < 0.0001); 44/265 (16.6%) patients would have received antibiotics with early-onset sepsis incidence 0.1/1000 live births (p < 0.025). One patient with culture-negative early-onset sepsis would not have received antibiotics with an early-onset sepsis incidence of 0.1/1000 live births. Conclusion Our evidence-based protocol for treatment decision-making of neonatal early-onset sepsis entails a further decrease of antibiotic overtreatment compared to early-onset sepsis risk calculator. No negative consequences for patients were observed.

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