Performance of the early-onset-sepsis calculator in Israeli newborns

Abstract

Riskin et al report a 2-year single-center prospective surveillance of performance of the early-onset-sepsis (EOS) calculator in Israeli infants born at 34 weeks' gestational age with one or more peripartum risk factors for EOS. The impact of use of the calculator in Israel compared with use in the US where it was invented and validated is of special interest because currently there is no recommendation for screening or intrapartum antibiotic prophylaxis (IAP) for group B Streptococcus (GBS) in Israel. The EOS calculator performed in Israeli infants with peripartum risk factor(s) similarly to its performance in this cohort of US infants and was associated with the expected decrease in laboratory testing and use of empiric antibiotics. However, during this surveillance period, GBS was the most common cause of EOS at this Israeli center, where GBS cases primarily were in infants without peripartum risk factors and who were asymptomatic at birth (which also was the case in the US prior to universal screening and IAP). It should be noted that approximately one-half of GBS EOS in the US currently occur in infants whose mothers' screening during pregnancy was negative. The bottom line is that although sepsis calculators appropriately applied can provide a level of confidence that permits providers to forego laboratory testing and excessive use of empiric antibiotic therapy, the critical element of optimal care of the neonate throughout the first day of life is repeated, templated clinical examinations with protocols in place for rapid response should abnormalities arise. Article page 71 ▸ Evaluation of Implementation of Early-Onset Sepsis Calculator in Newborns in IsraelThe Journal of PediatricsVol. 234PreviewTo evaluate the recommendations based on the early-onset sepsis (EOS) calculator in the first 2 years of its implementation in Israel. Full-Text PDF