{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T20:04:59Z","timestamp":1760385899318,"version":"3.40.5"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2021-0372_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The Northern California Kaiser-Permanente Neonatal Sepsis Risk Calculator (SRC) has proved to be safe and effective in reducing laboratory tests, hospital admissions, and administration of antibiotics to patients at risk of early-onset neonatal sepsis (EONS). Many studies have focused on maternal chorioamnionitis as the principal risk factor for EONS. We wanted to know if the use of the SRC could be equally efficient in the context of several other infectious risk factors (IRF), in addition to chorioamnionitis, such as intrapartum maternal fever, GBS colonization and\/or prolonged rupture of membranes (PROM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0372_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic study of neonates with\u00a0\u226535\u00a0weeks gestational age (GA), born in our tertiary university hospital during a period of 18\u00a0months. Patients were retrospectively assessed with the SRC and its recommendations were compared with the actual management. A bivariate analysis of perinatal interventions, and outcomes was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0372_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 5,885 newborns were born during the study period and 1783 mothers (31%) had at least one IRF. The incidence of culture-proven EONS was 0.5\u2030. The use of the SRC would have reduced laboratory evaluations (CBC and CRP) from 56.2 to 23.3%, and blood cultures, hospital admissions and antibiotic therapy from 22.9 to 15.5%, 17.8 and 7.6%, respectively. The management based on patients\u2019 symptoms would have shown a reduction to 7.5% in all the outcomes of interest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0372_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Both, the SRC and the management based on clinical findings, are safe and efficient to reduce the number of analytical studies, hospital admissions and administration of antibiotics to neonates with IRF.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2021-0372","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T22:15:37Z","timestamp":1652134537000},"page":"1150-1156","source":"Crossref","is-referenced-by-count":2,"title":["Management of neonates with 35\u00a0weeks of gestational age or more with infectious risk factors at birth: opportunities for improvement"],"prefix":"10.1515","volume":"50","author":[{"given":"Diego Andr\u00e9s","family":"Mazabanda L\u00f3pez","sequence":"first","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Taboada Rubinos","sequence":"additional","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Hern\u00e1ndez Ortega","sequence":"additional","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda del Mar","family":"P\u00e9rez Guedes","sequence":"additional","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"Urqu\u00eda Mart\u00ed","sequence":"additional","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6028-9158","authenticated-orcid":false,"given":"Ferm\u00edn","family":"Garc\u00eda-Mu\u00f1oz Rodrigo","sequence":"additional","affiliation":[{"name":"Division of Neonatology , Hospital Universitario Materno-Infantil de Las Palmas , Las Palmas de Gran Canaria , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2023092212342444133_j_jpm-2021-0372_ref_001","doi-asserted-by":"crossref","unstructured":"Hooven, TA, Polin, RA. Time to overhaul the \u201cRule out sepsis\u201d workup. Pediatrics 2017;140:e20171155. https:\/\/doi.org\/10.1542\/peds.2017-1155.","DOI":"10.1542\/peds.2017-1155"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_002","unstructured":"Verani, JR, McGee, L, Schrag, SJ. Division of bacterial diseases, national center for immunization and respiratory diseases, centers for disease control and prevention (CDC). Prevention of perinatal group B streptococcal disease\u2013revised guidelines from CDC. MMWR Recomm Rep (Morb Mortal Wkly Rep) 2010;59:1\u201336."},{"key":"2023092212342444133_j_jpm-2021-0372_ref_003","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Mu\u00f1oz Rodrigo, F, Gal\u00e1n Henr\u00edquez, G, Figueras Aloy, J, Garc\u00eda-Alix P\u00e9rez, A. Outcomes of very-low-birth-weight infants exposed to maternal clinical chorioamnionitis: a multicentre study. Neonatology 2014;106:229\u201334. https:\/\/doi.org\/10.1159\/000363127.","DOI":"10.1159\/000363127"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_004","doi-asserted-by":"crossref","unstructured":"Gal\u00e1n Henr\u00edquez, G, Garc\u00eda-Mu\u00f1oz Rodrigo, F. Chorioamnionitis and neonatal morbidity: current perspectives. Res Rep Neonatol 2017;7:41\u201352. https:\/\/doi.org\/10.2147\/rrn.s128751.","DOI":"10.2147\/RRN.S128751"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_005","doi-asserted-by":"crossref","unstructured":"Polin, RA, Committee on Fetus and Newborn. Management of neonates with suspected or proven early onset bacterial sepsis. Pediatrics 2012;129:1006\u201315. https:\/\/doi.org\/10.1542\/peds.2012-0541.","DOI":"10.1542\/peds.2012-0541"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_006","doi-asserted-by":"crossref","unstructured":"Benitz, WE, Wynn, JL, Polin, RA. Reappraisal of guidelines for management of neonates with suspected early-onset sepsis. J\u00a0Pediatr 2015;166:1070\u20134. https:\/\/doi.org\/10.1016\/j.jpeds.2014.12.023.","DOI":"10.1016\/j.jpeds.2014.12.023"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_007","doi-asserted-by":"crossref","unstructured":"Mukhopadhyay, S, Lieberman, ES, Puopolo, KM, Riley, LE, Johnson, LC. Effect of early-onset sepsis evaluations on in-hospital breastfeeding practices among asymptomatic term neonates. Hosp Pediatr 2015;5:203\u201310. https:\/\/doi.org\/10.1542\/hpeds.2014-0126.","DOI":"10.1542\/hpeds.2014-0126"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_008","doi-asserted-by":"crossref","unstructured":"Ottolini, MC, Lundgren, K, Mirkinson, LJ, Cason, S, Ottolini, MG. Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn. Pediatr Infect Dis J 2003;22:430\u20134. https:\/\/doi.org\/10.1097\/01.inf.0000068206.11303.dd.","DOI":"10.1097\/01.inf.0000068206.11303.dd"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_009","doi-asserted-by":"crossref","unstructured":"Cantoni, L, Ronfani, L, Da Riol, R, Demarini, S, Perinatal Study Group of the Region Friuli-Venezia Giulia. Physical examination instead of laboratory tests for most infants born to mothers colonized with group B Streptococcus: support for the Centers for Disease Control and Prevention\u2019s 2010 recommendations. J Pediatr 2013;163:568\u201373. https:\/\/doi.org\/10.1016\/j.jpeds.2013.01.034.","DOI":"10.1016\/j.jpeds.2013.01.034"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_010","doi-asserted-by":"crossref","unstructured":"Jackson, GL, Engle, WD, Sendelbach, DM, Vedro, DA, Josey, S, Vinson, J, et al.. Are complete blood cell counts useful in the evaluation of asymptomatic neonates exposed to suspected chorioamnionitis? Pediatrics 2004;113:1173\u201380. https:\/\/doi.org\/10.1542\/peds.113.5.1173.","DOI":"10.1542\/peds.113.5.1173"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_011","doi-asserted-by":"crossref","unstructured":"Puopolo, KM, Draper, D, Wi, S, Newman, TB, Zupancic, J, Lieberman, E, et al.. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics 2011;128:e1155\u201363. https:\/\/doi.org\/10.1542\/peds.2010-3464.","DOI":"10.1542\/peds.2010-3464"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_012","doi-asserted-by":"crossref","unstructured":"Escobar, GJ, Puopolo, KM, Wi, S, Turk, BJ, Kuzniewicz, MW, Walsh, EM, et al.. Stratification of risk of early-onset sepsis in newborns\u00a0\u226534\u00a0weeks\u2019 gestation. Pediatrics 2014;133:30\u20136. https:\/\/doi.org\/10.1542\/peds.2013-1689.","DOI":"10.1542\/peds.2013-1689"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_013","unstructured":"Northern California, Kaiser-Permanente. Neonatal early-onset sepsis calculator. Available from: https:\/\/neonatalsepsiscalculator.kaiserpermanente.org. Visited March 2021."},{"key":"2023092212342444133_j_jpm-2021-0372_ref_014","doi-asserted-by":"crossref","unstructured":"Kuzniewicz, MW, Puopolo, KM, Fischer, A, Walsh, EM, Li, S, Newman, TB, et al.. A quantitative, risk-based approach to the management of neonatal early-onset sepsis. JAMA Pediatr 2017;171:365\u201371. https:\/\/doi.org\/10.1001\/jamapediatrics.2016.4678.","DOI":"10.1001\/jamapediatrics.2016.4678"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_015","doi-asserted-by":"crossref","unstructured":"Strunk, T, Buchiboyina, A, Sharp, M, Nathan, E, Doherty, D, Patole, S. Implementation of the neonatal sepsis calculator in an Australian tertiary perinatal centre. Neonatology 2018;113:379\u201382. https:\/\/doi.org\/10.1159\/000487298.","DOI":"10.1159\/000487298"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_016","doi-asserted-by":"crossref","unstructured":"Achten, NB, Klingenberg, C, Benitz, WE, Stocker, M, Schlapbach, LJ, Giannoni, E, et al.. Association of use of the neonatal early-onset sepsis calculator with reduction in antibiotic therapy and safety: a systematic review and meta-analysis. JAMA Pediatr 2019;173:1032\u201340. https:\/\/doi.org\/10.1001\/jamapediatrics.2019.2825.","DOI":"10.1001\/jamapediatrics.2019.2825"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_017","doi-asserted-by":"crossref","unstructured":"Mukhopadhyay, S, Eichenwald, EC, Puopolo, KM. Neonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines. J Perinatol 2013;33:198\u2013205. https:\/\/doi.org\/10.1038\/jp.2012.96.","DOI":"10.1038\/jp.2012.96"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_018","doi-asserted-by":"crossref","unstructured":"Kuzniewicz, MW, Walsh, EM, Li, S, Fischer, A, Escobar, GJ. Development and implementation of an early-onset sepsis calculator to guide antibiotic management in late preterm and term neonates. Joint Comm J Qual Patient Saf 2016;42:232\u20139. https:\/\/doi.org\/10.1016\/s1553-7250(16)42030-1.","DOI":"10.1016\/S1553-7250(16)42030-1"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_019","doi-asserted-by":"crossref","unstructured":"Wortham, JM, Hansen, NI, Schrag, SJ, Hale, E, Van Meurs, K, S\u00e1nchez, PJ, et al.. Chorioamnionitis and culture-confirmed, early-onset neonatal infections. Pediatrics 2016;137:e20152323. https:\/\/doi.org\/10.1542\/peds.2015-2323.","DOI":"10.1542\/peds.2015-2323"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_020","doi-asserted-by":"crossref","unstructured":"Puopolo, KM, Benitz, WE, Zaoutis, TE, Committee on Fetus and Newborn; Committee on Infectious Diseases. Management of neonates born at\u00a0\u226535 0\/7\u00a0weeks\u2019 gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018;142: e20182894. https:\/\/doi.org\/10.1542\/peds.2018-2894.","DOI":"10.1542\/9781610023047-part05-management"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_021","doi-asserted-by":"crossref","unstructured":"Carola, D, Vasconcellos, M, Sloane, A, McElwee, D, Edwards, C, Greenspan, J, et al.. Utility of early-onset sepsis risk calculator for neonates born to mothers with chorioamnionitis. J Pediatr 2018;195:48\u201352.e1. https:\/\/doi.org\/10.1016\/j.jpeds.2017.11.045.","DOI":"10.1016\/j.jpeds.2017.11.045"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_022","doi-asserted-by":"crossref","unstructured":"Yoder, PR, Gibbs, RS, Blanco, JD, Castaneda, YS, St Clair, PJ. A prospective, controlled study of maternal and perinatal outcome after intra-amniotic infection at term. Am J Obstet Gynecol 1983;145:695\u2013701. https:\/\/doi.org\/10.1016\/0002-9378(83)90575-6.","DOI":"10.1016\/0002-9378(83)90575-6"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_023","unstructured":"Sperling, RS, Ramamurthy, RS, Gibbs, RS. A comparison of intrapartum versus immediate postpartum treatment of intra-amniotic infection. Obstet Gynecol 1987;70:861\u20135."},{"key":"2023092212342444133_j_jpm-2021-0372_ref_024","doi-asserted-by":"crossref","unstructured":"Braun, D, Bromberger, P, Ho, NJ, Getahun, D. Low rate of perinatal sepsis in term infants of mothers with chorioamnionitis. Am J Perinatol 2016;33:143\u201350. https:\/\/doi.org\/10.1055\/s-0035-1560045.","DOI":"10.1055\/s-0035-1560045"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_025","doi-asserted-by":"crossref","unstructured":"Newman, TB, Puopolo, KM, Wi, S, Draper, D, Escobar, GJ. Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics 2010;126:903\u20139. https:\/\/doi.org\/10.1542\/peds.2010-0935.","DOI":"10.1542\/peds.2010-0935"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_026","doi-asserted-by":"crossref","unstructured":"Cantey, JB, Baird, SD. Ending the culture of culture-negative sepsis in the neonatal ICU. Pediatrics 2017;140:e20170044. https:\/\/doi.org\/10.1542\/peds.2017-0044.","DOI":"10.1542\/peds.2017-0044"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_027","doi-asserted-by":"crossref","unstructured":"Schelonka, RL, Chai, MK, Yoder, BA, Hensley, D, Brockett, RM, Ascher, DP. Volume of blood required to detect common neonatal pathogens. J Pediatr 1996;129:275\u20138. https:\/\/doi.org\/10.1016\/s0022-3476(96)70254-8.","DOI":"10.1016\/S0022-3476(96)70254-8"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_028","doi-asserted-by":"crossref","unstructured":"Mazabanda L\u00f3pez, D, Reyes Su\u00e1rez, D, Urqu\u00eda Mart\u00ed, L, Garc\u00eda-Mu\u00f1oz Rodrigo, F. Rothia dentocariosa bacteremia in the newborn: causative pathogen or contaminant? Case Rep Perinat Med 2021;10:20210026. https:\/\/doi.org\/10.1515\/crpm-2021-0026.","DOI":"10.1515\/crpm-2021-0026"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_029","doi-asserted-by":"crossref","unstructured":"Hall, KK, Lyman, JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788\u2013802. https:\/\/doi.org\/10.1128\/cmr.00062-05.","DOI":"10.1128\/CMR.00062-05"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_030","doi-asserted-by":"crossref","unstructured":"Hofer, N, Zacharias, E, M\u00fcller, W, Resch, B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology 2012;102:25\u201336. https:\/\/doi.org\/10.1159\/000336629.","DOI":"10.1159\/000336629"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_031","doi-asserted-by":"crossref","unstructured":"Brown, JVE, Meader, N, Wright, K, Cleminson, J, McGuire, W. Assessment of C-reactive protein diagnostic test accuracy for late-onset infection in newborn infants: a systematic review and meta-analysis. JAMA Pediatr 2020;174:260\u20138. https:\/\/doi.org\/10.1001\/jamapediatrics.2019.5669.","DOI":"10.1001\/jamapediatrics.2019.5669"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_032","doi-asserted-by":"crossref","unstructured":"Cantey, JB, Bultmann, CR. C-reactive protein testing in late-onset neonatal sepsis: hazardous waste. JAMA Pediatr 2020;174:235\u20136. https:\/\/doi.org\/10.1001\/jamapediatrics.2019.5684.","DOI":"10.1001\/jamapediatrics.2019.5684"},{"key":"2023092212342444133_j_jpm-2021-0372_ref_033","doi-asserted-by":"crossref","unstructured":"Flayhart, D, Borek, AP, Wakefield, T, Dick, J, Carroll, KC. Comparison of BACTEC PLUS blood culture media to BacT\/Alert FA blood culture media for detection of bacterial pathogens in samples containing therapeutic levels of antibiotics. J Clin Microbiol 2007;45:816\u201321. https:\/\/doi.org\/10.1128\/jcm.02064-06.","DOI":"10.1128\/JCM.02064-06"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2021-0372\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2021-0372\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T12:37:15Z","timestamp":1695386235000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpm-2021-0372\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,11]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,5,10]]},"published-print":{"date-parts":[[2022,10,26]]}},"alternative-id":["10.1515\/jpm-2021-0372"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2021-0372","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"type":"print","value":"0300-5577"},{"type":"electronic","value":"1619-3997"}],"subject":[],"published":{"date-parts":[[2022,5,11]]}}}