使用疑似羊膜腔内感染和新生儿检查对新生儿早发型败血症进行分类风险分层
Categorical Risk Stratification for Neonatal Early Onset Sepsis using Suspected Intraamniotic Infection and the Newborn Exam.
作者信息
Rick Anne-Marie, Copp Elizabeth, Buckley Abigail, Yanowitz Toby, Martin Judith, Shaikh Nader, Switzer Galen, Hooven Thomas, Beigi Richard
机构信息
University of Pittsburgh.
Three Rivers Rowing Association.
出版信息
Res Sq. 2023 Aug 1:rs.3.rs-2838294. doi: 10.21203/rs.3.rs-2838294/v1.
OBJECTIVE
To determine test characteristics of categorical risk stratification for early onset sepsis (EOS) using maternal criteria for suspected intraamniotic infection (IAI) and/or newborn exam and compare them to the EOS calculator.
STUDY DESIGN
Retrospective 1:3 case-control study of late preterm/term infants with bacterial culture growth obtained <72 hours of life. For categorical approach, infants of mothers with suspected IAI or equivocal/ill appearing were presumed high-risk for EOS and blood culture obtained. For calculator, estimated probability of EOS and care recommendations were recorded from online calculator. Test characteristics were compared with McNemar's test; recommendation for blood culture was considered a "positive" test.
RESULT
52 cases and 172 controls were included. Compared to the calculator, the categorical approach had higher sensitivity 90%(95%CI:79-96%) vs 67% (95%CI:54-79%) but lower specificity 85%(95%CI:78-89%) vs. 92%(95%CI:87-96%). 10% of cases were not identified by either.
CONCLUSION
A categorical approach using suspected IAI/newborn exam offers good EOS discrimination and is comparable to the calculator.
目的
使用疑似羊膜腔内感染（IAI）的母体标准和/或新生儿检查来确定早发型败血症（EOS）分类风险分层的检测特征，并将其与EOS计算器进行比较。
研究设计
对出生后<72小时获得细菌培养结果的晚期早产/足月儿进行回顾性1:3病例对照研究。对于分类方法，疑似IAI或表现不明确/患病母亲的婴儿被假定为EOS高危，并进行血培养。对于计算器，从在线计算器记录EOS的估计概率和护理建议。使用McNemar检验比较检测特征；血培养建议被视为“阳性”检测。
结果
纳入52例病例和172例对照。与计算器相比，分类方法具有更高的敏感性，分别为90%（95%CI：79-96%）和67%（95%CI：54-79%），但特异性较低，分别为85%（95%CI：78-89%）和92%（95%CI：87-96%）。10%的病例两种方法均未识别出。
结论
使用疑似IAI/新生儿检查的分类方法对EOS具有良好的鉴别能力，与计算器相当。
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