{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:43:08Z","timestamp":1774572188391,"version":"3.50.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n            Objective\u2003Performing lumbar punctures (LP) in all clinically suspected neonatal sepsis, as per current recommendations, results in many \u201cnegative\u201d LPs. LPs are not without their own risks. With the intention of minimizing unnecessary LPs among neonates, we aimed to identify a subgroup at extremely low risk of developing possible meningitis so that an LP could be safely avoided in it.<\/jats:p><jats:p>\n            Study Design\u2003This was a prospective, observational, and cross-sectional study in a level III neonatal unit. We included 300 episodes, in which LP was performed for suspected sepsis. We recorded a comprehensive set of clinico-demographic variables, laboratory parameters, sickness score, organ dysfunction score, and organ localization and studied association of these factors with \u201cdefinite (culture positive) or possible meningitis.\u201d \u201cPossible\u201d meningitis was defined with liberal criteria, intending not to miss any meningitis. A subgroup without a single factor associated with \u201cdefinite or possible meningitis\u201d was analyzed for incidence of meningitis.<\/jats:p><jats:p>\n            Results\u2003There were 121 episodes of \u201cdefinite or possible meningitis\u201d among 300 episodes of sepsis. On unadjusted analysis, apnea, irritability, high-pitched cry, seizures, neutrophilia, high C-reactive protein (CRP), score for acute neonatal physiology and perinatal extension II (SNAPPE-II), urine output, and leukomalacia were associated with \u201cdefinite or possible\u201d meningitis (p\u2009&lt;\u20090.05). On multivariate analysis, no apneas, no neutrophilia, and normal CRP were independently associated with \u201cno definite or possible meningitis.\u201d Nevertheless, the subgroup that had a combination of no apneas, no neutrophilia, and normal CRP (n\u2009=\u2009118) had a 29% probability of \u201cdefinite or possible meningitis.\u201d<\/jats:p><jats:p>\n            Conclusion\u2003The lowest risk subgroup had a 29% chance of having \u201cdefinite or possible\u201d meningitis. There is no subgroup that we could identify among neonates with suspected sepsis, in which it is safe to avoid an LP.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1714397","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T23:50:51Z","timestamp":1595375451000},"page":"099-105","source":"Crossref","is-referenced-by-count":12,"title":["Is Lumbar Puncture Avoidable in Low-Risk Neonates with Suspected Sepsis?"],"prefix":"10.1055","volume":"39","author":[{"given":"Richie","family":"Dalai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sourabh","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0850-3118","authenticated-orcid":false,"given":"Arnab","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkataseshan","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 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