早发型败血症：一项比较连续临床观察与实验室检测的队列研究。
Early-onset sepsis: a cohort study comparing serial clinical observation with laboratory testing.
机构信息
Neonatology Department, General University Hospital, Castellon, Spain.
Department of Pediatrics, Manises Hospital, Valencia, Spain.
出版信息
J Perinatol. 2021 Oct;41(10):2482-2487. doi: 10.1038/s41372-021-01138-y. Epub 2021 Jul 8.
OBJECTIVE
Early onset sepsis (EOS) remains a serious and potentially fatal illness. We aimed to demonstrate that serial clinical observation (SCO) is a feasible strategy associated with fewer laboratory evaluations and unnecessary antibiotic use.
STUDY DESIGN
We compared the admissions and antibiotic therapy in neonates ≥35 weeks' gestation at risk for EOS in a prospective cohort after the implementation of a new protocol based on SCO (n = 381) with a historical cohort which received laboratory testing (n = 417).
RESULTS
There was a significant reduction in admissions for suspected sepsis (7.2% vs 2.9%, p = 0.006) and the use of antibiotics (6.1% vs 0.7%, p = 0.000) in the cohort based on SCO. There was no delay in diagnosis.
CONCLUSIONS
SCO in neonates ≥35 weeks' gestation at risk for EOS, including chorioamnionitis-exposed infants, is a feasible measure that reduces laboratory evaluations and the overuse of antibiotics respecting the bonding mother-infant.
目的
早发性败血症（EOS）仍然是一种严重且潜在致命的疾病。我们旨在证明连续临床观察（SCO）是一种可行的策略，与减少实验室评估和不必要的抗生素使用相关。
研究设计
在一项基于 SCO 的新方案实施后，我们比较了高危 EOS 的胎龄≥35 周新生儿的住院和抗生素治疗情况。该方案纳入了前瞻性队列研究（n=381），并与接受实验室检测的历史队列（n=417）进行了比较。
结果
SCO 组疑似败血症（7.2% vs 2.9%，p=0.006）和抗生素使用（6.1% vs 0.7%，p=0.000）的住院率显著降低。诊断没有延迟。
结论
SCO 可用于胎龄≥35 周、有 EOS 风险的新生儿，包括有绒毛膜羊膜炎暴露史的婴儿，是一种可行的措施，可减少实验室评估和不必要的抗生素使用，同时尊重母婴关系。
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