SJOG Midland Public Hospital, Australia.
SJOG Midland Public Hospital, Australia.
Pediatr Neonatol. 2021 Sep;62(5):512-521. doi: 10.1016/j.pedneo.2021.05.005. Epub 2021 May 19.
Sepsis is a major cause of mortality and morbidity in neonates. With the improvement in health care standards, the incidence of neonatal Early Onset Sepsis (EOS) has reduced significantly. A recent Web-based EOS-calculator has been introduced with the aim to reduce the use of IV antibiotics in neonates. The role of the EOS-calculator has yet to be ascertained in this regional Special Care Nursery (SCN) in Western Australia. This study aims at examining the local incidence of culture proven EOS and the role of the EOS calculator.
It is a retrospective study examining all newborns ≥35 weeks gestation throughout 2019 (Jan-Dec 2019) who received IV-antibiotics. The local incidence of culture-proven EOS was established and applied onto the EOS calculator. The recommended management by the EOS-calculator was cross-examined with the local EOS guideline. Overall proportion of reduction in IV antibiotics use was formulated. Other relevant laboratory data extracted was analysed with Pearson's correlation test with the EOS scores.
Total included sample was n = 252 with an annual birth of 1880s indicating 13.4% of all neonates born throughout year 2019 was treated with IV antibiotics. The local incidence of culture-proven EOS was 0.5/1000. By applying the EOS-calculator, a significant reduction of IV antibiotics usage from 13.4% to 3.9% (z value 10.4, p < 0.0001) could be achieved in this cohort. Sixty three percent of neonates who received IV antibiotics in this cohort were classified as 'clinically well' based on the EOS-calculator.
The EOS-calculator could reduce the use of IV antibiotics in the neonatal population significantly in this regional SCN (from 13.4% to 3.9%). Judicial use of IV antibiotics is imperative as part of the holistic care for the neonates. Implementation of the EOS-calculator must be done strategically considering the local incidence of EOS and other health care policies.
败血症是新生儿死亡和发病的主要原因。随着医疗保健标准的提高，新生儿早发性败血症（EOS）的发病率显著降低。最近引入了一种基于网络的 EOS 计算器，旨在减少新生儿静脉注射抗生素的使用。在西澳大利亚的这个区域特殊护理病房（SCN）中，EOS 计算器的作用尚未确定。本研究旨在检查当地培养证实的 EOS 发生率和 EOS 计算器的作用。
这是一项回顾性研究，检查了 2019 年所有≥35 周妊娠的新生儿（2019 年 1 月至 12 月），他们接受了静脉注射抗生素。确定了当地培养证实的 EOS 发生率，并将其应用于 EOS 计算器。用 EOS 计算器推荐的管理方法与当地 EOS 指南进行交叉检查。计算了 IV 抗生素使用总体减少比例。用 Pearson 相关检验分析了其他相关实验室数据与 EOS 评分的相关性。
共纳入 252 例样本，年出生率为 1880 年代，表明 2019 年全年出生的所有新生儿中有 13.4%接受了 IV 抗生素治疗。当地培养证实的 EOS 发生率为 0.5/1000。应用 EOS 计算器，本队列中 IV 抗生素使用率从 13.4%显著降低至 3.9%（z 值 10.4，p<0.0001）。本队列中接受 IV 抗生素治疗的新生儿中，63%根据 EOS 计算器被归类为“临床情况良好”。
EOS 计算器可显著降低本区域 SCN 中新生儿人群 IV 抗生素的使用（从 13.4%降至 3.9%）。作为新生儿整体护理的一部分，审慎使用 IV 抗生素至关重要。EOS 计算器的实施必须根据当地 EOS 发生率和其他医疗保健政策进行战略性考虑。
