Use of Early-Onset Sepsis Risk Calculator for Neonates ≥ 34 Weeks in a Large Tertiary Neonatal Centre, Saudi Arabia

Halima Career,Faisal A Abduljabar Alaklobi,Fahad Hamad Aljobair,Roya Huseynova,Latifa Bin Mahmoud,Parameaswari  P Jaganathan,Adli Abdelrahim,Ogtay Huseynov

doi:10.7759/cureus.14620

Halima Career, Faisal A Abduljabar Alaklobi + Show 6 more

Open Access

https://doi.org/10.7759/cureus.14620

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Journal: Cureus	Publication Date: Apr 21, 2021
Citations: 2	License type: cc-by

Affiliation: King Saud Medical City, Azerbaijan Medical University

Abstract

Early-onset sepsis (EOS) refers to sepsis with onset before 72 hours of life. Kaiser Permanente Calculator (KPC) or EOS risk calculator is an advanced multivariate risk model for predicting EOS in infants.ObjectiveTo examine the EOS risk calculator effect for predicting neonatal EOS, the necessity for laboratory tests, antibiotic usage, and length of hospital stay among the term and late-preterm newborns.MethodIn this cross-sectional study, we evaluated 44 cases of neonates ≥34 weeks of gestation started on empiric antibiotics within 72 hours after birth due to suspected EOS at the neonatal intensive care unit (NICU). The study site is a 1,500-bed teaching hospital, with around 4,500 annual deliveries, 70 beds in the level II and level III tertiary care NICU. We calculated the risk of the incidence of EOS as one per 1000 live births. Then we retrospectively calculated the probability of neonatal early-onset infection at birth based on the EOS risk calculator and assigned each neonate to one of the recommended categories of the calculator. The primary outcome was to evaluate the infection risk calculator's effect for predicting neonatal EOS and antibiotic usage among the term and late-preterm newborns ≥34 weeks of gestation.ResultsIn our data, EOS calculator showed unnecessary antibiotic usage for 12 (27.3%) neonates [relative risk reduction (RRR) 27.2%; 95% confidence interval (CI) 20.3% - 35.7%)]. EOS risk calculator implementation may decrease in the number of NICU admission (RRR 20.4%; 95% CI 14.3% - 28%), laboratory tests (RRR 20.4%; 95% CI 14.3% - 28%), and length of stay (RRR 25%; 95% CI 38% - 95%).ConclusionEOS calculator could be considered a strategic and objective implementation for managing EOS that can limit unnecessary laboratory tests, reduce antibiotic usage, and length of stay related to EOS. Our findings ensure a multicenter, randomized study evaluating the safety and general use of the calculator for EOS sepsis in Saudi Arabia's clinical practice.

Highlights

Early-onset sepsis (EOS) remains a severe problem for neonates associated with the significant cause of infant morbidity and mortality in both high and low-income countries [1]
EOS risk calculator implementation may decrease in the number of neonatal intensive care unit (NICU) admission (RRR 20.4%; 95% CI 14.3% - 28%), laboratory tests (RRR 20.4%; 95% CI 14.3% - 28%), and length of stay (RRR 25%; 95% CI 38% - 95%)
By applying the EOS calculator in well-appearing and equivocal groups, we found that antibiotic usage could significantly decrease from 100.0% to 0 (P=0.0009) and from 100.0% to 33.3% (P=0.0035), respectively

Summary

Introduction

Early-onset sepsis (EOS) remains a severe problem for neonates associated with the significant cause of infant morbidity and mortality in both high and low-income countries [1]. According to World Health Organization (WHO) in 2015, the incidence of EOS overall worldwide was one to 5/1000 live births, with the mortality rate of late preterm babies ≥ 35 weeks around 2-3% [2]. Early-onset neonatal sepsis incidence in Arab countries is 0.5-1.4 per 1000 live births [3]. How to cite this article Huseynova R, Bin Mahmoud L, Hamad Aljobair F, et al (April 21, 2021) Use of Early-Onset Sepsis Risk Calculator for Neonates ≥ 34 Weeks in a Large Tertiary Neonatal Centre, Saudi Arabia.

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