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胎龄≥35 周的疑似或确诊早发性细菌性败血症新生儿的处理。

Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis.

出版信息

Pediatrics. 2018 Dec;142(6). doi: 10.1542/peds.2018-2894.

Abstract

The incidence of neonatal early-onset sepsis (EOS) has declined substantially over the last 2 decades, primarily because of the implementation of evidence-based intrapartum antimicrobial therapy. However, EOS remains a serious and potentially fatal illness. Laboratory tests alone are neither sensitive nor specific enough to guide EOS management decisions. Maternal and infant clinical characteristics can help identify newborn infants who are at risk and guide the administration of empirical antibiotic therapy. The incidence of EOS, the prevalence and implications of established risk factors, the predictive value of commonly used laboratory tests, and the uncertainties in the risk/benefit balance of antibiotic exposures all vary significantly with gestational age at birth. Our purpose in this clinical report is to provide a summary of the current epidemiology of neonatal sepsis among infants born at ≥35 0/7 weeks' gestation and a framework for the development of evidence-based approaches to sepsis risk assessment among these infants.

摘要

在过去的 20 年中,新生儿早发性败血症(EOS)的发病率大幅下降,主要原因是实施了基于证据的分娩期抗菌治疗。然而,EOS 仍然是一种严重且可能致命的疾病。仅通过实验室检查既不够敏感也不够特异,无法指导 EOS 管理决策。母亲和婴儿的临床特征有助于识别有风险的新生儿,并指导经验性抗生素治疗的应用。EOS 的发生率、已确定危险因素的流行率和影响、常用实验室检查的预测价值,以及抗生素暴露的风险/获益平衡中的不确定性,均随出生时的胎龄显著变化。我们撰写本临床报告的目的是总结胎龄≥35 0/7 周出生的婴儿中新生儿败血症的当前流行病学情况,并为这些婴儿中败血症风险评估的循证方法的制定提供框架。

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