title: Use of polymerase chain reaction as a diagnostic tool for neonatal sepsis can result in a decrease in use of antibiotics and total neonatal intensive care unit length of stay.
abstract: OBJECTIVE
  To retrospectively determine if a negative 16S ribosomal RNA (rRNA) polymerase chain reaction (PCR) (PCR(-)) could lead to a decrease in the number of antibiotic doses and neonatal intensive care unit (NICU) length of stay (LOS) for infants admitted to the NICU for presumed early-onset sepsis (EOS) with negative blood culture results (BC(-)).
  
  
  METHODS
  Analysis included 419 infants, greater than 35 weeks gestational age, with PCR(-), BC(-) and LOS > 48 h. Both the investigators and clinical care team were unaware of the PCR results. The actual number of antibiotic doses (AAD) administered was compared to an estimated number of antibiotics doses (EAD) that would have been given until PCR(-) results were available by 18 h. The number of antibiotic doses saved was calculated as (AAD-EAD). The actual NICU LOS in hours (aLOS) for a subset of infants who remained in the hospital primarily for antibiotic therapy was compared to an estimated LOS (eLOS) if infants with PCR(-) were discharged from the NICU when clinically stable. The number of hours saved was calculated as (aLOS-eLOS).
  
  
  RESULTS
  Approximately eight antibiotic doses and 85 NICU hours per infant could be saved using PCR(-) results available at 18 h.
  
  
  CONCLUSIONS
  Use of 16S rRNA PCR could decrease the number of antibiotics doses and NICU LOS for infants admitted for EOS. This may facilitate: (1) earlier NICU discharge; (2) parental satisfaction; and (3) decreased health care costs.
authors.affiliation: Department of Newborn Medicine, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA. bbrozanski@magee.edu
authors.forename: B S
authors.initials: BS
authors.lastname: Brozanski
authors.forename: J G
authors.initials: JG
authors.lastname: Jones
authors.forename: M J
authors.initials: MJ
authors.lastname: Krohn
authors.forename: J A
authors.initials: JA
authors.lastname: Jordan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000097:blood; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D016133:Polymerase Chain Reaction / Q000706:statistics & numerical data*; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S