scholarly journals ASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS

2020 ◽  
Vol 8 (2) ◽  
pp. 108
Author(s):  
Trias Kusuma Sari ◽  
Irwanto Irwanto ◽  
Risa Etika ◽  
Mahendra Tri Arif Sampurna ◽  
Ni Made Mertaniasih
Keyword(s):  
Acute Phase ◽  
Early Onset ◽  
P Value ◽  
Risk Calculator ◽  
C Reactive Protein ◽  
Laboratory Examination ◽  
Reactive Protein ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Infection Parameters

C-reactive protein (CRP) is an acute-phase reactant protein that is primarily induced by the IL-6 action during the acute phase of an inflammatory or infectious process. Bacterial infection is a potent stimulus, leading to a rapid elevation of CRP levels within hours while the CBC and symptom are often misleading and/or absent. American Academy of paediatrics (AAP) is recommended routine blood examination test Complete Blood Count (CBC), C-reactive protein (CRP), and blood culture along with empirical antibiotic in neonates with early onset sepsis risk (EOS) risk even asymptomatic. Previous study is showed there were no correlation of CRP and EOS risk. The aim of this study is to evaluate the CRP and CBC profile in neonate with risk of EOS.  Methods of this study is using the sepsis risk calculator (SRC) to calculate the probability of neonatal early onset sepsis (EOS) based on maternal risk and infant’s clinical presentation. Neonates with ≥34 weeks of gestation who were started on antibiotic treatment after laboratory examination and blo odculture were taken. EOS risk estimation were compared including CRP, leukocyte, and thrombocyte count. ANOVA applied to distinguished laboratory examination between stratified risk groups. The result is showed using 82 subjects who met the inclusion and exclusion criterias, EOS risk level was stratified into green, yellow, and red group. The p value of CRP level, platelets, white blood cell were 0.35,0.54 and 0.48 where p value was considered as significant if < 0.5. The conclusion of this study is there were no correlation of CRP level and EOS riskASSOCIATION BETWEEN SEPSIS RISK CALCULATOR AND INFECTION PARAMETERS FOR NEONATES WITH RISK OF EARLY ONSET SEPSIS

scholarly journals Infants Born to Mothers with Clinical Chorioamnionitis: A Cross-Sectional Survey on the Use of Early-Onset Sepsis Risk Calculator and Prolonged Use of Antibiotics

2018 ◽  
Vol 36 (04) ◽  
pp. 428-433 ◽  
Author(s):  
Marina Ayrapetyan ◽  
David Carola ◽  
Satyan Lakshminrusimha ◽  
Vineet Bhandari ◽  
Zubair Aghai
Keyword(s):  
Early Onset ◽  
Complete Blood Count ◽  
Risk Calculator ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Level Ii ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Clear Guideline

Objective To evaluate variations in practice for the management of neonates born to mothers with clinical chorioamnionitis. Methods This was a prospective cross-sectional survey consisting of 10 multiple choice questionnaires distributed to 2,900 members of the Perinatal Section of American Academy of Pediatrics. Variations in responses were assessed and compared between the various groups. Results A total of 682 members (23.5%) completed the survey; 169 (24.8%) indicated that they use the neonatal early-onset sepsis (EOS) risk calculator for the management of neonates born to mothers with clinical chorioamnionitis. More respondents from the western region of United States and level III units are using the EOS risk calculator compared with the south and level II units. Approximately 44% of the respondents indicated that they will not stop antibiotics at 48 to 72 hours in asymptomatic neonates born to mothers with chorioamnionitis with negative blood culture if the complete blood count (CBC) and C-reactive protein (CRP) are abnormal. Conclusion A large number of practitioners are using the neonatal EOS risk calculator for neonates born to mothers with chorioamnionitis. Despite a clear guideline from the Committee on Fetus and Newborn, almost 44% will treat healthy-appearing neonates born to mothers with chorioamnionitis with a prolonged course of antibiotics solely for abnormal CBC or CRP.

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

Utility of Early-Onset Sepsis Risk Calculator for Neonates Born to Mothers with Chorioamnionitis

2018 ◽  
Vol 195 ◽  
pp. 48-52.e1 ◽  
Author(s):  
David Carola ◽  
Mansi Vasconcellos ◽  
Amy Sloane ◽  
Dorothy McElwee ◽  
Caroline Edwards ◽  
...  
Keyword(s):  
Early Onset ◽  
Risk Calculator ◽  
Early Onset Sepsis ◽  
Sepsis Risk

Implementation and Evaluation of the Early-Onset Sepsis Risk Calculator in a High-Risk University Nursery

2017 ◽  
Vol 57 (9) ◽  
pp. 1080-1085 ◽  
Author(s):  
Jessica B. Beavers ◽  
Shasha Bai ◽  
Jennifer Perry ◽  
Jordan Simpson ◽  
Sara Peeples
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Risk Calculator ◽  
Admission Rates ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Control And Prevention ◽  
Nicu Admission

There is growing interest in the Kaiser early-onset sepsis (EOS) risk calculator though institutions are hesitant to deviate from the Centers for Disease Control and Prevention guidelines and implement this in their hospitals. We describe the process of implementing routine use of the risk calculator in term and late preterm newborns delivered to mothers with chorioamnionitis in a level III neonatal intensive care unit (NICU). A retrospective chart review of infants delivered to mothers with chorioamnionitis from 2011 to 2014 was performed. Implementation of routine use of the calculator began in January 2015; preintervention and postintervention data were analyzed after a 9-month period of routine use. Following implementation, NICU admission rates, number of blood cultures drawn, and rates of antibiotic use dropped by 54%, 42%, and 59%, respectively ( P < .001). No negative outcomes were reported. In this article, we describe how the calculator was safely implemented in our NICU while decreasing the number of interventions.

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.

scholarly journals A sepsis risk calculator can decrease antibiotic exposure in neonatal early‐onset sepsis screening

2020 ◽  
Vol 109 (10) ◽  
pp. 2166-2167
Author(s):  
Rebeca Cavazos ◽  
Monika Patil ◽  
K. Suresh Gautham
Keyword(s):  
Early Onset ◽  
Antibiotic Exposure ◽  
Risk Calculator ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Sepsis Screening

Comparison of the management recommendations of the Kaiser Permanente neonatal early-onset sepsis risk calculator (SRC) with NICE guideline CG149 in infants ≥34 weeks’ gestation who developed early-onset sepsis

2020 ◽  
Vol 105 (6) ◽  
pp. 581-586
Author(s):  
Rachel Morris ◽  
Steve Jones ◽  
Sujoy Banerjee ◽  
Andrew Collinson ◽  
Hannah Hagan ◽  
...  
Keyword(s):  
Early Onset ◽  
Risk Calculator ◽  
Kaiser Permanente ◽  
Nice Guideline ◽  
Early Onset Sepsis ◽  
Nice Guidance ◽  
Sepsis Risk ◽  
Cerebrospinal Fluid Culture ◽  
Management Recommendations ◽  
Fluid Culture

ObjectiveTo compare the management recommendations of the Kaiser Permanente neonatal early-onset sepsis risk calculator (SRC) with National Institute for Health and Care Excellence (NICE) guideline CG149 in infants ≥34 weeks’ gestation who developed early-onset sepsis (EOS).DesignRetrospective multicentre study.SettingFive maternity services in South West of England and Wales.Patients70 infants with EOS (<72 hours) confirmed on blood or cerebrospinal fluid culture.MethodsRetrospective virtual application of NICE and SRC through review of maternal and neonatal notes.Main outcome measureThe number of infants recommended antibiotics by 4 hours of birth.ResultsThe incidence of EOS ≥34 weeks was 0.5/1000 live births. Within 4 hours of birth, antibiotics were recommended for 39 infants (55.7%) with NICE, compared with 27 (38.6%) with SRC. The 12 infants advised early treatment by NICE but not SRC remained well, only one showing transient mild symptoms after 4 hours. Another four babies received antibiotics by 4 hours outside NICE and SRC guidance. The remaining 27 infants (38.6%) received antibiotics when symptomatic after 4 hours. Only one infant who was unwell from birth, died. Eighty-one per cent of all EOS infants were treated for clinical reasons rather than for risk factors alone.ConclusionWhile both tools were poor in identifying EOS within 4 hours, NICE was superior to SRC in identifying asymptomatic cases. Currently, four out of five EOS have symptoms at first identification, the majority of whom present within 24 hours of birth. Antibiotic stewardship programmes using SRC should include enhanced observation for infants currently treated within NICE guidance.

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