Περίληψη:
To assess the potential benefit from the implementation of the Kaiser
Permanente early-onset sepsis calculator (EOS-C), in terms of antibiotic
use and requested laboratory tests, in a network of neonatal intensive
care units (NICUs) in Greece, and to determine the incidence of
early-onset sepsis (EOS) in Greek NICUs, a prospective surveillance
study was conducted in 7 NICUs between April 2018 and June 2019. Data
were collected for all newborns >= 34 weeks’ gestation receiving empiric
antibiotic therapy within the first 3 days of life. The number of live
births and positive blood or cerebrospinal fluid cultures within the
first 3 days of life were used for calculation of EOS incidence.
Evaluation of possible impact of implementing the calculator was done by
comparing the clinicians’ recorded management to the calculator’s
suggested course of action. The unit-specific incidence of
culture-proven EOS ranged between 0 and 2.99/1000 live births. The
weighted incidence rate for all 7 units was 1.8/1000 live births.
Management of EOS guided by the calculator could lead to a reduction of
empiric antibiotic initiation up to 100% for the group of
“well-appearing” neonates and 86% for “equivocal,” lowering
exposure to antibiotics by 4.2 and 3.8 days per neonate, respectively.
Laboratory tests for blood cultures drawn could be reduced by up to
100% and 68%, respectively. Sensitivity of the EOS-C in identifying
neonates with positive blood cultures was high. Conclusion: Management
strategies based on the Kaiser Permanente neonatal sepsis calculator may
significantly reduce antibiotic exposure, invasive diagnostic
procedures, and hospitalizations in late preterm and term neonates. What
is Known: center dot Neonates are frequently exposed to antibiotics for
presumed EOS. center dot The Kaiser Permanente sepsis calculator can
reduce antibiotic exposure in neonates.. What is New: center dot EOS
calculator can be an effective antibiotic stewardship tool in a high
prescribing country and can reduce invasive diagnostic procedures and
mother-baby separation. center dot Incidence of EOS in Greece is higher
compared to other European countries.
Συγγραφείς:
Kopsidas, Ioannis
Molocha, Nafsika-Maria
Kourkouni, Eleni and
Coffin, Susan
Gkentzi, Despoina
Chorianopoulou, Evangelia and
Dimitriou, Gabriel
Kapetanaki, Anastasia
Karavana, Georgia and
Lithoxopoulou, Maria
Polychronaki, Maria
Roilides, Emmanuel and
Triantafyllidou, Pinelopi
Triantafyllou, Christos
Tsopela,
Grammatiki-Christina
Tsouvala, Emmanouela
Tsolia, Maria N. and
Zaoutis, Theoklis
Spyridis, Nikos
