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

TitleNeonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines.
Publication TypeJournal Article
Year of Publication2013
AuthorsMukhopadhyay S, Eichenwald EC, Puopolo KM
JournalJ Perinatol
Volume33
Issue3
Pagination198-205
Date Published03/2013
ISSN1476-5543
KeywordsAge of Onset, Antibiotic Prophylaxis, Asymptomatic Diseases, Centers for Disease Control and Prevention (U.S.), Female, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Male, Neonatal Screening, Practice Guidelines as Topic, Sepsis, Streptococcal Infections, Streptococcus agalactiae, United States
Abstract

OBJECTIVE: 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.

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

RESULT: 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.

CONCLUSION: 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.

DOI10.1038/jp.2012.96
Alternate JournalJ Perinatol
PubMed ID22814941
PubMed Central IDPMC3782314
Grant ListUL1 RR025758 / RR / NCRR NIH HHS / United States