title: Performance of the definitions of the systemic inflammatory response syndrome and sepsis in neonates.
abstract: OBJECTIVE
  The aim of this study was to examine the applicability of the definitions of the systemic inflammatory response syndrome (SIRS) and sepsis to neonates during the first 3 days of life.
  
  
  METHODS
  This is a retrospective study of all term neonates hospitalized within the first 24 h of life from 2004 to 2010 at our neonatal intensive care unit.
  
  
  RESULTS
  Of 476 neonates, 30 (6 %) had a diagnosis of culture-proven early-onset sepsis (EOS) and 81 (17 %) had culture-negative clinical EOS or suspected EOS. SIRS and sepsis criteria were applied to 116 (24 %) and 61 (13 %) neonates, respectively. Of 30 neonates with culture proven, EOS 14 (53 %) fulfilled SIRS and sepsis criteria. The single diagnostic criterion of SIRS applied to 20 % (hypothermia or fever), 43 % (white blood cell count/immature-to-total neutrophil ratio), 87 % (respiratory symptoms), and 33 % (cardiocirculatory symptoms) of all neonates with culture-proven EOS.
  
  
  CONCLUSIONS
  The definitions of SIRS and sepsis did not apply to about half of all cases of culture-proven EOS. An evidence-based approach to find the appropriate criteria for defining EOS in the neonate is needed.
authors.affiliation: Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria. nora.hofer@medunigraz.at
authors.forename: Nora
authors.initials: N
authors.lastname: Hofer
authors.forename: Eva
authors.initials: E
authors.lastname: Zacharias
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Müller
authors.forename: Bernhard
authors.initials: B
authors.lastname: Resch
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis; D008297:Male; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis*; D009626:Terminology as Topic