外观正常的新生儿早发性败血症评估：美国疾病控制与预防中心 GBS 指南变化的预计影响。
Neonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines.
机构信息
Division of Newborn Medicine, Children's Hospital Boston, Boston, MA, USA.
出版信息
J Perinatol. 2013 Mar;33(3):198-205. doi: 10.1038/jp.2012.96. Epub 2012 Jul 19.
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.
摘要
目的
确定（a）≥35 孕周出生且接受过早期发病（EOS）评估并接受过产后抗生素治疗的无症状婴儿比例；（b）评估的原因和结果；（c）当将疾病控制与预防中心（CDC）2010 年指南应用于该研究人群时预期的变化。
研究设计
对 2008-2009 年在一家大型产科中心出生的≥35 孕周的婴儿进行回顾性队列研究。
结果
在所研究的 7226 名婴儿中，有 1062 名（14.7%）接受了 EOS 评估，其中一半接受了经验性抗生素治疗。70.4%的评估是由于产妇产时发热，但有 23%是由于单独使用不充分的 B 组链球菌（GBS）预防措施引起的。发现了 3 例血培养阳性感染病例。
结论
需要改进方法来识别有 EOS 风险的无症状婴儿，以减少不必要的评估和抗生素暴露。向 2010 年 CDC GBS 指南过渡可能会使这些婴儿中四分之一的 EOS 评估被取消。
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