Blood culture indications in critically ill neonates : a multicenter prospective cohort study
- Author
- Evelien Verstraete (UGent) , Ludo Mahieu, James d’Haese, Kris De Coen (UGent) , Jerina Boelens (UGent) , Dirk Vogelaers (UGent) and Stijn Blot (UGent)
- Organization
- Abstract
- Due to potential lethality of healthcare-associated sepsis (HAS), a low threshold for blood culturing and antimicrobial therapy (ABT) initiation is accepted. We assessed variability in the trigger for blood culturing between three neonatal intensive care units. A multicenter prospective cohort study was conducted. In newborns with suspicion of HAS, 10 predefined clinical signs, nosocomial sepsis (NOSEP) score, C-reactive protein, ABT initiation, and risk factors were registered at time of culturing. Outcome was lab-confirmed HAS, defined according to the NeoKISS-criteria. Two hundred ninety-nine suspected HAS episodes were considered in 212 infants, of which 118 had birth-weight ae<currency> 1500 g; proportion of lab-confirmed HAS per suspected episode was 30/192 (center 1), 28/60 (center 2), and 8/47 (center 3) (p < 0.001). Median C-reactive protein and number of clinical signs at time of culturing differed between centers 1, 2, and 3 (respectively 11 vs. 5 vs. 3 mg/L, p = 0.001; 1 sign [IQR 0-2, center 1] vs. 3 signs [IQR 2-4, centers 2 and 3], p < 0.001). Median NOSEP score at time of culturing was 5 (IQR 3-8, center 1), 5 (IQR 3-9, center 2), and 8 (IQR 5-11, center 3) (p = 0.016). Difference in ABT initiation was noticed (82 vs. 93 vs. 74%, p = 0.05). Conclusion: Center heterogeneity in sampling practice is substantial. Optimizing sampling practice can be recommended.
- Keywords
- Newborn, Blood culture, Sepsis, Clinical sign, INTENSIVE-CARE-UNIT, BIRTH-WEIGHT INFANTS, LATE-ONSET SEPSIS, NOSOCOMIAL SEPSIS, STREAM INFECTIONS, ANTIBIOTIC USE, RISK-FACTORS, DIAGNOSTIC MARKERS, CLINICAL SIGNS, SURVEILLANCE
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8572635
- MLA
- Verstraete, Evelien, et al. “Blood Culture Indications in Critically Ill Neonates : A Multicenter Prospective Cohort Study.” EUROPEAN JOURNAL OF PEDIATRICS, vol. 177, no. 10, 2018, pp. 1565–72, doi:10.1007/s00431-018-3203-1.
- APA
- Verstraete, E., Mahieu, L., d’Haese, J., De Coen, K., Boelens, J., Vogelaers, D., & Blot, S. (2018). Blood culture indications in critically ill neonates : a multicenter prospective cohort study. EUROPEAN JOURNAL OF PEDIATRICS, 177(10), 1565–1572. https://doi.org/10.1007/s00431-018-3203-1
- Chicago author-date
- Verstraete, Evelien, Ludo Mahieu, James d’Haese, Kris De Coen, Jerina Boelens, Dirk Vogelaers, and Stijn Blot. 2018. “Blood Culture Indications in Critically Ill Neonates : A Multicenter Prospective Cohort Study.” EUROPEAN JOURNAL OF PEDIATRICS 177 (10): 1565–72. https://doi.org/10.1007/s00431-018-3203-1.
- Chicago author-date (all authors)
- Verstraete, Evelien, Ludo Mahieu, James d’Haese, Kris De Coen, Jerina Boelens, Dirk Vogelaers, and Stijn Blot. 2018. “Blood Culture Indications in Critically Ill Neonates : A Multicenter Prospective Cohort Study.” EUROPEAN JOURNAL OF PEDIATRICS 177 (10): 1565–1572. doi:10.1007/s00431-018-3203-1.
- Vancouver
- 1.Verstraete E, Mahieu L, d’Haese J, De Coen K, Boelens J, Vogelaers D, et al. Blood culture indications in critically ill neonates : a multicenter prospective cohort study. EUROPEAN JOURNAL OF PEDIATRICS. 2018;177(10):1565–72.
- IEEE
- [1]E. Verstraete et al., “Blood culture indications in critically ill neonates : a multicenter prospective cohort study,” EUROPEAN JOURNAL OF PEDIATRICS, vol. 177, no. 10, pp. 1565–1572, 2018.
@article{8572635,
abstract = {{Due to potential lethality of healthcare-associated sepsis (HAS), a low threshold for blood culturing and antimicrobial therapy (ABT) initiation is accepted. We assessed variability in the trigger for blood culturing between three neonatal intensive care units. A multicenter prospective cohort study was conducted. In newborns with suspicion of HAS, 10 predefined clinical signs, nosocomial sepsis (NOSEP) score, C-reactive protein, ABT initiation, and risk factors were registered at time of culturing. Outcome was lab-confirmed HAS, defined according to the NeoKISS-criteria. Two hundred ninety-nine suspected HAS episodes were considered in 212 infants, of which 118 had birth-weight ae<currency> 1500 g; proportion of lab-confirmed HAS per suspected episode was 30/192 (center 1), 28/60 (center 2), and 8/47 (center 3) (p < 0.001). Median C-reactive protein and number of clinical signs at time of culturing differed between centers 1, 2, and 3 (respectively 11 vs. 5 vs. 3 mg/L, p = 0.001; 1 sign [IQR 0-2, center 1] vs. 3 signs [IQR 2-4, centers 2 and 3], p < 0.001). Median NOSEP score at time of culturing was 5 (IQR 3-8, center 1), 5 (IQR 3-9, center 2), and 8 (IQR 5-11, center 3) (p = 0.016). Difference in ABT initiation was noticed (82 vs. 93 vs. 74%, p = 0.05).
Conclusion: Center heterogeneity in sampling practice is substantial. Optimizing sampling practice can be recommended.}},
author = {{Verstraete, Evelien and Mahieu, Ludo and d’Haese, James and De Coen, Kris and Boelens, Jerina and Vogelaers, Dirk and Blot, Stijn}},
issn = {{0340-6199}},
journal = {{EUROPEAN JOURNAL OF PEDIATRICS}},
keywords = {{Newborn,Blood culture,Sepsis,Clinical sign,INTENSIVE-CARE-UNIT,BIRTH-WEIGHT INFANTS,LATE-ONSET SEPSIS,NOSOCOMIAL SEPSIS,STREAM INFECTIONS,ANTIBIOTIC USE,RISK-FACTORS,DIAGNOSTIC MARKERS,CLINICAL SIGNS,SURVEILLANCE}},
language = {{eng}},
number = {{10}},
pages = {{1565--1572}},
title = {{Blood culture indications in critically ill neonates : a multicenter prospective cohort study}},
url = {{http://doi.org/10.1007/s00431-018-3203-1}},
volume = {{177}},
year = {{2018}},
}
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