Title

Neonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines.

Year of Publication

2013

Number of Pages

198-205

Date Published

03/2013

ISSN Number

1476-5543

Abstract

<p><strong>OBJECTIVE: </strong>To determine (a) the proportion of asymptomatic infants born at ≥35 weeks gestation evaluated for early-onset sepsis (EOS) and exposed to postnatal antibiotics; (b) reasons for and outcomes of the evaluations, and (c) anticipated changes when applying the Centers for Disease Control and Prevention (CDC) 2010 guidelines to this study population.</p>

<p><strong>STUDY DESIGN: </strong>Retrospective cohort study of infants born at ≥35 weeks gestation in 2008-2009 in a large maternity center.</p>

<p><strong>RESULT: </strong>Out of the 7226 infants that met the study criteria: 1062 (14.7%) were evaluated for EOS and half of those evaluated, received empiric antibiotics. 70.4% of evaluations were performed owing to maternal intrapartum fever, but 23% were prompted by inadequate Group B Streptococcus (GBS) prophylaxis alone. Three cases of blood culture-proven infection were identified.</p>

<p><strong>CONCLUSION: </strong>Improved approaches are needed to identify asymptomatic infants who are at risk for EOS to decrease unnecessary evaluations and antibiotic exposure. Transition to the 2010 CDC GBS guidelines may eliminate a quarter of EOS evaluations among these infants.</p>

DOI

10.1038/jp.2012.96

Alternate Title

J Perinatol

PMID

22814941

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