Stratification of Risk of Early-Onset Sepsis in Newborns ≥34 Weeks’ Gestation

@article{Escobar2014StratificationOR,
  title={Stratification of Risk of Early-Onset Sepsis in Newborns ≥34 Weeks’ Gestation},
  author={Gabriel J. Escobar and Karen M Puopolo and Soora Wi and Benjamin J. Turk and Michael W Kuzniewicz and Eileen M. Walsh and Thomas B. Newman and John A. F. Zupancic and Ellice S. Lieberman and David Draper},
  journal={Pediatrics},
  year={2014},
  volume={133},
  pages={30 - 36}
}
OBJECTIVE To define a quantitative stratification algorithm for the risk of early-onset sepsis (EOS) in newborns ≥ 34 weeks' gestation. [] Key MethodMETHODS We conducted a retrospective nested case-control study that used split validation. Data collected on each infant included sepsis risk at birth based on objective maternal factors, demographics, specific clinical milestones, and vital signs during the first 24 hours after birth.
A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis
TLDR
Clinical care algorithms based on individual infant estimates of EOS risk derived from a multivariable risk prediction model reduced the proportion of newborns undergoing laboratory testing and receiving empirical antibiotic treatment without apparent adverse effects.
Use of Early-Onset Sepsis Risk Calculator for Neonates ≥ 34 Weeks in a Large Tertiary Neonatal Centre, Saudi Arabia
Early-onset sepsis (EOS) refers to sepsis with onset before 72 hours of life. Kaiser Permanente Calculator (KPC) or EOS risk calculator is an advanced multivariate risk model for predicting EOS in
Early-onset sepsis risk calculator: a review of its effectiveness and comparative study with our evidence-based local guidelines
TLDR
An evidence-based protocol entails a further decrease of antibiotic overtreatment compared to EOS calculator and some missed cases of culture-positive EOS have also been described.
Delivery Characteristics and the Risk of Early-Onset Neonatal Sepsis.
TLDR
Risk of EOS among infants with low-risk delivery characteristics is extremely low, and a substantial proportion of these infants are administered antibiotics, which should inform empirical antibiotic management decisions among infants born at all gestational ages.
Early-onset Sepsis and Antibiotic Exposure in Term Infants: A Nationwide Population-based Study in Norway
TLDR
In this registry-based study, the incidence of culture-confirmed EOS was in line with previous international reports and the mortality was very low and a large proportion of infants without infection were treated with antibiotics.
Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies.
TLDR
The rate of E coli infection increased among very low-birth-weight infants and associated mortality disproportionately occurred in preterm infants, and ongoing surveillance should monitor antibiotic susceptibilities of EOS pathogens.
Management of Neonates Born at ≥35 0/7 Weeks’ Gestation With Suspected or Proven Early-Onset Bacterial Sepsis
TLDR
The purpose in this clinical report is to provide a summary of the current epidemiology of neonatal sepsis among infants born at ≥35 0/7 weeks’ gestation and a framework for the development of evidence-based approaches to sepsi risk assessment among these infants.
Implementation of the Neonatal Sepsis Calculator in an Australian Tertiary Perinatal Centre
TLDR
Application of this clinical decision support tool may reduce the number of infants undergoing investigations and empirical treatment for suspected sepsis, as well as the cost to the NHS.
Predictors of early-onset neonatal sepsis or death among newborns born at <32 weeks of gestation
TLDR
Earlier gestational age at the time of delivery, intrapartum fever, meconium, and lower birth weight are independently associated with early-onset neonatal sepsis or death among deliveries occurring at <32 weeks of gestation; these factors can be used to create a model with fair predictive capability.
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