Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2022 May;58(5):863-867. doi: 10.1111/jpc.15860. Epub 2022 Jan 6.
To determine if any cases of culture-positive neonatal early-onset sepsis (EOS) would be missed using the neonatal EOS calculator, when compared with current guidelines and practices.
Retrospective audit of all neonates born at ≥35 weeks and admitted to Royal Brisbane and Women's Hospital with EOS from January 2014 to December 2020. A missed case was defined as antibiotic therapy not being recommended within 24 h of birth. Management recommendations according to the neonatal EOS calculator were compared with current guidelines and current practices.
There were significantly more missed cases using the neonatal EOS calculator compared to the current guideline and current management groups. Using the neonatal EOS calculator, 11 neonates (35%, 95% confidence interval 19.2-54.6%) would not have received antibiotics by 24 h of age. In comparison, only one neonate (3%, 95% confidence interval 0.1-16.7%) would not have received antibiotics by 24 h of age using the current guidelines. In terms of the current practice in the cohort of patients, two neonates (6%) did not receive antibiotics by 24 h of age.
The significantly higher rate of missed cases using the neonatal EOS calculator compared with current guidelines and practice supports the concerns many neonatologists have regarding safety of the neonatal EOS calculator.
与现行指南和实践相比，通过新生儿早发性败血症（EOS）计算器来判断是否会漏诊任何培养阳性的新生儿早发性败血症病例。
对 2014 年 1 月至 2020 年 12 月期间在皇家布里斯班妇女医院出生且患有 EOS 的≥35 周新生儿进行回顾性审核。将未进行治疗的病例定义为出生后 24 小时内未推荐使用抗生素。比较新生儿 EOS 计算器的管理建议与现行指南和现行实践。
与现行指南和现行管理组相比，使用新生儿 EOS 计算器的漏诊病例明显更多。使用新生儿 EOS 计算器，11 例新生儿（35%，95%置信区间 19.2-54.6%）在 24 小时内未接受抗生素治疗。相比之下，只有一名新生儿（3%，95%置信区间 0.1-16.7%）在使用现行指南时未在 24 小时内接受抗生素治疗。在该患者组的现行实践中，有 2 例新生儿（6%）在 24 小时内未接受抗生素治疗。
与现行指南和实践相比，新生儿 EOS 计算器的漏诊病例率明显更高，这支持了许多新生儿科医生对新生儿 EOS 计算器安全性的担忧。
