Rapid Detection of Microorganisms in Blood Cultures of Newborn Infants Utilizing an Automated Blood Culture System

Garcia‐Prats, Joseph A.; Cooper, Timothy R; Schneider, Virginia; Stager, Charles E.; Hansen, Thomas N.

doi:10.1542/peds.105.3.523

Cited by 142 publications

(104 citation statements)

References 13 publications

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“…Though there are several methods for rapid detection of microorganisms in blood cultures of newborn infants using automated blood culture system, DNA probe and fluorometric detection systems [9][10][11], still HSS can be employed as a useful test to distinguish the infected from the non infected infants. It has high sensitivity and specificity, the certainty of sepsis being present with higher scores.…”

Section: Discussionmentioning

confidence: 99%

Significance of Hematological Scoring System (HSS) in Early Diagnosis of Neonatal Sepsis

Narasimha

Kumar

2011

Indian J Hematol Blood Transfus

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Neonates are easily prone for bacterial infection. Diagnosis of neonatal septicemia may be difficult as the early signs of sepsis may be subtle and different at different gestational ages. The present study was undertaken to assess the significance of the hematological scoring system (HSS) for early detection of neonatal sepsis. About 50 peripheral blood smears of all newborns collected were analysed for neonatal sepsis using the HSS of Rodwell et al. (J Pediatr 112:761-767, 1988). Analysis in our study found that an abnormal immature to total neutrophil ratio (I:T) followed by an abnormal immature to mature neutrophil ratio (I:M) were the most sensitive indicators in identifying infants with sepsis. The HSS is a simple, quick, cost effective tool which can be used as a screening test for early diagnosis of neonatal sepsis.

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Section: Discussionmentioning

confidence: 99%

Significance of Hematological Scoring System (HSS) in Early Diagnosis of Neonatal Sepsis

Narasimha

Kumar

2011

Indian J Hematol Blood Transfus

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“…Completed part 2 surveys were received from 278 clinicians, including 277 attending neonatologists or fellows-72% of eligible clinicians at the 35 hospitals. There was a median of 6 respondents per NICU (range: [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Thirteen NICUs (38%) also participated in the Vermont Oxford Neonatal Network, and 9 (26%) participated in the National Nosocomial Infections Surveillance (NNIS) system high-risk nursery component.…”

Section: Characteristics Of Participating Nicusmentioning

confidence: 99%

Evaluation and Treatment of Neonates With Suspected Late-Onset Sepsis: A Survey of Neonatologists’ Practices

Rubin

Sánchez

Siegel³

et al. 2002

Pediatrics

150

111

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ABSTRACT.Objective. To ascertain current diagnostic and treatment practices for suspected late-onset sepsis in infants in neonatal intensive care units (NICUs) and identify areas that may benefit from clinical practice guidelines.Methods. During June 2000, we conducted a multicenter survey of neonatologists and infection control professionals regarding practices related to late-onset sepsis in NICUs at children's hospitals participating in the Pediatric Prevention Network.Results. Personnel at 35 hospitals with NICUs completed surveys; 34 were infection control professionals, and 278 were neonatology clinicians, primarily attending neonatologists or neonatology fellows. At these facilities, coagulase-negative staphylococci (CoNS) were the most frequent blood culture isolate from infants with lateonset sepsis accounting for 54% of bloodstream infections. When late-onset sepsis was suspected, 83% of clinicians drew only 1 blood culture when no central venous catheter was present or when a central vascular was present with no blood return. Thirty-two percent obtained 1 or more C-reactive protein concentration determinations. Sixty percent of clinicians prescribed a vancomycin-containing regimen for a 900 g, 3-week-old infant with suspected late-onset sepsis. The presence of a central venous catheter or shock increased empiric vancomycin use. The presence of methicillin-resistant Staphylococcus aureus in the NICU did not increase vancomycin use, but a vancomycin restriction policy decreased empiric vancomycin use. Clinicians at an individual NICU tended to have similar empiric antibiotic-prescribing practices: in 29 (83%) of 35 centers >75% of respondents had similar practice with regard to prescribing a vancomycin-containing regimen for empiric therapy. Forty-seven percent to 85% completed a full course of antimicrobials when a single blood culture was obtained and grew CoNS, but a significantly lower percentage of respondents (22%-47%) completed a full course when 1 of 2 blood cultures obtained grew CoNS. Eleven percent of respondents removed an umbilical catheter at the time of suspected sepsis, but fewer than 5% removed a nonumbilical central venous catheter for suspected sepsis. L ate-onset sepsis-invasive infection occurring in neonates older than 3 days-occurs in approximately 10% of all neonates and in Ͼ25% of very low birth weight infants (Յ1500 g) who are hospitalized in neonatal intensive care units (NICUs). 1 In NICUs, these infections are often associated with vascular catheters, and coagulase-negative staphylococci (CoNS) are the most commonly reported pathogens, accounting for Ͼ50% of bloodstream infections. 2,3 In this setting, the vast majority of CoNS are resistant to methicillin. NICU infants with suspected late-onset sepsis are typically treated with empiric antimicrobial therapy that often includes vancomycin. However, there are national recommendations that vancomycin use in hospitals be restricted because exposure of patients to vancomycin is a risk factor for emergence of vancomycinresistant ...

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“…Current blood-culturing systems identify the great majority of pathologic organisms before 48 hours. 11 Prolonged antibiotic use may be associated with necrotizing enterocolitis and death in extremely low birth weight infants. 12 …”

Section: Avoid Routine Continuation Of Antibiotic Therapy Beyond 48 Hmentioning

confidence: 99%

Choosing Wisely in Newborn Medicine: Five Opportunities to Increase Value

et al. 2015

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BACKGROUND: The use of unnecessary tests and treatments contributes to health care waste. The “Choosing Wisely” campaign charges medical societies with identifying such items. This report describes the identification of 5 tests and treatments in newborn medicine. METHODS: A national survey identified candidate tests and treatments. An expert panel of 51 individuals representing 28 perinatal care organizations narrowed the list over 3 rounds of a modified Delphi process. In the final round, the panel was provided with Grading of Recommendation, Assessment, Development and Evaluation (GRADE) literature summaries of the top 12 tests and treatments. RESULTS: A total of 1648 candidate tests and 1222 treatments were suggested by 1047 survey respondents. After 3 Delphi rounds, the expert panel achieved consensus on the following top 5 items: (1) avoid routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux disease or for treatment of apnea and desaturation in preterm infants, (2) avoid routine continuation of antibiotic therapy beyond 48 hours for initially asymptomatic infants without evidence of bacterial infection, (3) avoid routine use of pneumograms for predischarge assessment of ongoing and/or prolonged apnea of prematurity, (4) avoid routine daily chest radiographs without an indication for intubated infants, and (5) avoid routine screening term-equivalent or discharge brain MRIs in preterm infants. CONCLUSIONS: The Choosing Wisely Top Five for newborn medicine highlights tests and treatments that cannot be adequately justified on the basis of efficacy, safety, or cost. This list serves as a starting point for quality improvement efforts to optimize both clinical outcomes and resource utilization in newborn care.

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Rapid Detection of Microorganisms in Blood Cultures of Newborn Infants Utilizing an Automated Blood Culture System

Cited by 142 publications

References 13 publications

Significance of Hematological Scoring System (HSS) in Early Diagnosis of Neonatal Sepsis

Significance of Hematological Scoring System (HSS) in Early Diagnosis of Neonatal Sepsis

Evaluation and Treatment of Neonates With Suspected Late-Onset Sepsis: A Survey of Neonatologists’ Practices

Choosing Wisely in Newborn Medicine: Five Opportunities to Increase Value

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