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Screening for early-onset neonatal sepsis on the kaiser permanente sepsis risk calculator could reduce neonatal antibiotic usage by two-thirds

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Pediatric Investigation 2022年第3期6卷 171-178页

作者： Michelle Fernandes Lucinda Winckworth Lyrille Lee Madiha Akram Simon Struthers The Department of Neonatal Medicine and the Neonatal Intensive Care Unit Princess Anne HospitalUniversity Hospitals Southampton NHS Foundation TrustSouthamptonUK The MRC Lifecourse Epidemiology Centre and Human Development and Health Academic Unit Faculty of MedicineUniversity of SouthamptonSouthamptonUK Nuffield Department of Women’s and Reproductive Health John Radcliffe HospitalUniversity of OxfordOxfordUK Department of Pediatrics Royal Hampshire County HospitalWinchesterUK

Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in ***:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the kaiser permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,*** projections were obtained using its virtual risk ***:Sixty infants received PAb within the first 72 h of birth during the study *** these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven *** on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>*** below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>***:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.

关键词： Early onset neonatal sepsis kaiser permanente sepsis risk calculator NICE guidelines Parenteral antibiotics

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