Frequency and timing of symptoms in infants screened for sepsis: effectiveness of a sepsis-screening pathway.
To determine the frequency and timing of symptoms and to evaluate the effectiveness of a sepsis-screening pathway in term and near-term infants, data were collected prospectively for a period of 1 year from December 1, 2000, to November 30, 2001. Results confirmed that a sepsis-screening pathway using a combination of at least 2 serial complete blood cell count and C-reactive protein measurements in both symptomatic and asymptomatic infants is a safe, simple strategy that prevents unnecessary treatment of infants with risk factors with antibiotics. However, most infants with presumed or suspected early-onset sepsis are symptomatic. Routine treatment of asymptomatic infants with risk factors or prior treatment with intrapartum antibiotics is unnecessary. A combined approach of screening in the presence of risk factors and /or symptoms of sepsis and adequate follow-up for infants discharged at less than 72 hours of age may help reduce unnecessary treatment of infants with antibiotics.
Madan
Ashima
A
Stanford University School of Medicine, S-226 Grant Building, 300 Pasteur Dr., Stanford, CA 94305-5208, USA.
Adams
Marian M
MM
Philip
Alistair G S
AG
D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D001774:Blood Chemical Analysis; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007363:Intensive Care Units, Neonatal; D007958:Leukocyte Count; D008297:Male; D015997:Neonatal Screening / Q000592:standards* / Q000639:trends; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors
D002097:C-Reactive Protein