Neonatal Sepsis Workups in Infants ≥2000 Grams at Birth: A Population-Based Study

Abstract

The risk of bacterial infection in asymptomatic newborns is low. Evidence-based observation and treatment protocols could be defined based on a limited set of predictors: maternal fever, chorioamnionitis, initial neonatal examination, and absolute neutrophil count. Many missed opportunities for treating mothers and infants exist.

Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard

“…14,15 Early Start maintains its own database, which links (1) responses to the Prenatal Substance Abuse Screening Questionnaire, (2) patient assessment results as recorded by the Early Start Specialist and (3) follow-up visit summary data. Adverse neonatal and maternal outcomes were obtained from in-patient visit data and a research database, the Neonatal Minimum Data Set (NMDS).…”

“…The data sources were linked to develop a comprehensive database for analysis. [14][15][16][17] During the study period, KPNC used universal urine toxicology screening tests as part of the initial standard labs of prenatal care along with the self-assessment questionnaire as measures of substance abuse. All pregnant patients were asked to consent in writing to have urine toxicology testing performed at the first prenatal visit (referred to as the 'universal test') and during pregnancy as needed based on treatment recommendations of the Early Start Specialist and the Obstetrician.…”

Can neutrophil responses in very low birth weight infants predict the organisms responsible for late-onset bacterial or fungal sepsis?

“…A particular lack of sensitivity and poor predictive value of either of these parameters have been noted in early-onset sepsis by several investigators. [9][10][11] These parameters have neither been studied extensively in VLBW preterm infants with late-onset sepsis, nor has the organism-specific neutrophilic response. In addition, the newer birth weight-adjusted reference ranges recommended by Mouzinho et al 6 have not been examined in late-onset sepsis.…”

Antibiotic Use in Neonates of Birth-weight < 2000 G Surviving to Discharge

“…Amongst symptomatic infants, blood culture positivity rates vary widely in different studies, ranging from 0.79% [11] to 36.7% [5]. In our study, 9.1% of symptomatic infants had a positive blood culture.…”

“…In a retrospective study of 18299 neonates weighing 2000 g or more at birth of whom 2785 (15.2%) were symptomatic, Escobar and co-workers report antibiotic use in 1217 (43.7%) infants [11]. In a Canadian study of 20488 neonates admitted to NICU, 75% received antibiotics [9].…”