Comparison of the Kaiser-Permanente Neonatal early Onset Sepsis Risk Calculator with the Centers for Disease Control and Prevention guidelines
2Department of Paediatrics, Kaplan Medical Centre, ישראל
3Infectious Diseases Unit, Kaplan Medical Centre, ישראל
4The Hebrew University School of Medicine, Hebrew University and Hadassah Medical Centre, ישראל
Aim: The aim of our study was to compare the Kaiser-Permanente (KP) early onset sepsis (EOS) calculator management recommendations to the United States Centers for Disease Control and Prevention (CDC) guidelines for newborn infants who developed EOS.
Methods: Included in this observational retrospective cohort study were 50 newborn infants with documented EOS born at Kaplan Medical Center between 2001-2018. We retrospectively calculated the EOS risk at four hours of birth and evaluated whether the KP calculator recommended antibiotic treatment versus the CDC guidelines.
Results: EOS was diagnosed in 50 of 109,877 newborn infants (≥34 weeks), 18 of them were symptomatic, five had equivocal clinical status, and 27 were asymptomatic by four hours of birth. The KP EOS risk calculator according to its clinical status classification, recommended treatment for 19 neonates (38%), 18 being symptomatic. The calculator did not recommend antibiotic treatment for any of the infants with equivocal clinical status. The CDC guidelines recommended antibiotic treatment to 27 (54%) newborn infants, including eight asymptomatic ones.
Conclusion: The CDC guidelines were superior to the KP EOS risk calculator in identifying equivocal and asymptomatic EOS cases by four hours of birth. Enhanced observation is recommended when using the KP calculator