{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T04:01:46Z","timestamp":1770436906295,"version":"3.49.0"},"reference-count":30,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Chorioamnionitis (CAM) is a major risk factor for neonatal sepsis. At our institution, neonates exposed to CAM and intrapartum antibiotics are treated with prolonged antimicrobial therapy if laboratory values are abnormal despite a sterile blood culture. Recently, the Committee on the Fetus and Newborn (COFN) recommended a similar strategy for treating neonates exposed to CAM. Our objective was to determine the frequency of abnormal laboratory parameters in term and late-preterm neonates exposed to CAM and evaluate the implication of recent COFN guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This retrospective data analysis included late-preterm and term neonates exposed to CAM. Laboratory parameters, clinical symptoms and the number of infants treated with prolonged antibiotics were determined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 554 infants met the inclusion criteria. Eighty-three infants (14.9%) had an abnormal immature to total neutrophil ratio (&amp;gt;0.2) and 121 infants (22%) had an abnormal C-reactive protein level (&amp;gt;1 mg\/dL) at 12 hours of age. A total of 153 infants (27.6%) had an abnormal immature to total neutrophil ratio and\/or abnormal C-reactive protein level at 12 hours of age. Only 4 (0.7%) of 554 infants had a positive blood culture result. A total of 134 (24.2%) infants were treated with prolonged antibiotics (112 [20.2%] were treated solely based on abnormal laboratory data). Lumbar puncture was performed in 120 (21.6%) infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>When managed by using a strategy similar to recent COFN guidelines, a large number of term and late-preterm infants exposed to CAM who had sterile blood culture findings were treated with prolonged antibiotic therapy due to abnormal laboratory findings. They were also subjected to additional invasive procedures and had a longer duration of hospitalization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-2927","type":"journal-article","created":{"date-parts":[[2014,5,6]],"date-time":"2014-05-06T01:36:25Z","timestamp":1399340185000},"page":"992-998","source":"Crossref","is-referenced-by-count":89,"title":["Role of Guidelines on Length of Therapy in Chorioamnionitis and Neonatal Sepsis"],"prefix":"10.1542","volume":"133","author":[{"given":"Courtney","family":"Kiser","sequence":"first","affiliation":[{"name":"Pediatrics\/Neonatology, Thomas Jefferson University\/Nemours, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Nawab","sequence":"additional","affiliation":[{"name":"Pediatrics\/Neonatology, Thomas Jefferson University\/Nemours, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"McKenna","sequence":"additional","affiliation":[{"name":"Pediatrics\/Neonatology, Thomas Jefferson University\/Nemours, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubair H.","family":"Aghai","sequence":"additional","affiliation":[{"name":"Pediatrics\/Neonatology, Thomas Jefferson University\/Nemours, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2014,6,1]]},"reference":[{"key":"2021121015592971600_B1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/jmf.16.2.13.16","article-title":"Early diagnosis of bacterial infection in the neonate.","volume":"16","author":"Volante","year":"2004","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2021121015592971600_B2","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease\u2014revised guidelines from CDC, 2010.","volume":"59","author":"Verani","year":"2010","journal-title":"MMWR Recomm Rep"},{"issue":"2","key":"2021121015592971600_B3","first-page":"274","article-title":"Chorioamnionitis and the prognosis for term infants.","volume":"94","author":"Alexander","year":"1999","journal-title":"Obstet Gynecol"},{"issue":"2 pt 1","key":"2021121015592971600_B4","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1542\/peds.106.2.256","article-title":"Neonatal sepsis workups in infants &gt;\/=2000 grams at birth: a population-based study.","volume":"106","author":"Escobar","year":"2000","journal-title":"Pediatrics"},{"issue":"6","key":"2021121015592971600_B5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1097\/00006250-198812000-00001","article-title":"A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection.","volume":"72","author":"Gibbs","year":"1988","journal-title":"Obstet Gynecol"},{"issue":"6","key":"2021121015592971600_B6","first-page":"861","article-title":"A comparison of intrapartum versus immediate postpartum treatment of intra-amniotic infection.","volume":"70","author":"Sperling","year":"1987","journal-title":"Obstet Gynecol"},{"issue":"1","key":"2021121015592971600_B7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0732-8893(02)00480-7","article-title":"Detection of group B streptococcal bacteremia in simulated intrapartum antimicrobial prophylaxis.","volume":"45","author":"Hsu","year":"2003","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"5","key":"2021121015592971600_B8","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1542\/peds.2012-0541","article-title":"Management of neonates with suspected or proven early-onset bacterial sepsis.","volume":"129","author":"Polin","year":"2012","journal-title":"Pediatrics"},{"issue":"1","key":"2021121015592971600_B9","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1542\/peds.2013-1310","article-title":"Prevention and management of infants with suspected or proven neonatal sepsis.","volume":"132","author":"Brady","year":"2013","journal-title":"Pediatrics"},{"issue":"5","key":"2021121015592971600_B10","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/00006454-198705000-00005","article-title":"Sepsis screen in neonates with evaluation of plasma fibronectin.","volume":"6","author":"Gerdes","year":"1987","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"2021121015592971600_B11","doi-asserted-by":"crossref","DOI":"10.1542\/peds.102.4.e41","article-title":"Serial serum C-reactive protein levels in the diagnosis of neonatal infection.","volume":"102","author":"Benitz","year":"1998","journal-title":"Pediatrics"},{"issue":"1","key":"2021121015592971600_B12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0022-3476(79)80096-7","article-title":"The neonatal blood count in health and disease. I. Reference values for neutrophilic cells.","volume":"95","author":"Manroe","year":"1979","journal-title":"J Pediatr"},{"issue":"5","key":"2021121015592971600_B13","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1542\/peds.113.5.1173","article-title":"Are complete blood cell counts useful in the evaluation of asymptomatic neonates exposed to suspected chorioamnionitis?","volume":"113","author":"Jackson","year":"2004","journal-title":"Pediatrics"},{"issue":"1","key":"2021121015592971600_B14","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/INF.0b013e31822ffc17","article-title":"Use of leukocyte counts in evaluation of early-onset neonatal sepsis.","volume":"31","author":"Murphy","year":"2012","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"2021121015592971600_B15","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/01.inf.0000068206.11303.dd","article-title":"Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn.","volume":"22","author":"Ottolini","year":"2003","journal-title":"Pediatr Infect Dis J"},{"issue":"12","key":"2021121015592971600_B16","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/00006454-199012000-00006","article-title":"Changes in the differential white blood cell count in screening for group B streptococcal sepsis.","volume":"9","author":"Greenberg","year":"1990","journal-title":"Pediatr Infect Dis J"},{"key":"2021121015592971600_B17","article-title":"Serial neutrophil values facilitate predicting the absence of neonatal early-onset sepsis.","author":"Mikhael","journal-title":"J Pediatr"},{"key":"2021121015592971600_B18","first-page":"172","author":"McCracken"},{"issue":"6","key":"2021121015592971600_B19","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1097\/MOP.0b013e32835a1ac8","article-title":"Normal neonatal microbiome variation in relation to environmental factors, infection and allergy.","volume":"24","author":"Madan","year":"2012","journal-title":"Curr Opin Pediatr"},{"issue":"6","key":"2021121015592971600_B20","doi-asserted-by":"crossref","first-page":"F456","DOI":"10.1136\/fetalneonatal-2011-301373","article-title":"Gut microbial colonisation in premature neonates predicts neonatal sepsis.","volume":"97","author":"Madan","year":"2012","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021121015592971600_B21","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1542\/peds.2007-1232","article-title":"Neonatal antibiotic treatment is a risk factor for early wheezing.","volume":"121","author":"Alm","year":"2008","journal-title":"Pediatrics"},{"issue":"3","key":"2021121015592971600_B22","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1136\/adc.2010.187732","article-title":"Early, prolonged use of postnatal antibiotics increased the risk of necrotising enterocolitis.","volume":"95","author":"Cotton","year":"2010","journal-title":"Arch Dis Child Educ Pract Ed"},{"issue":"3","key":"2021121015592971600_B23","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jpeds.2011.02.035","article-title":"Antibiotic exposure in the newborn intensive care unit and the risk of necrotizing enterocolitis.","volume":"159","author":"Alexander","year":"2011","journal-title":"J Pediatr"},{"issue":"4","key":"2021121015592971600_B24","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-2302A","article-title":"Empirical antibiotic therapy for suspected early-onset bacterial sepsis.","volume":"130","author":"Cotten","year":"2012","journal-title":"Pediatrics"},{"issue":"4","key":"2021121015592971600_B25","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2012-2302C","article-title":"Response to the American Academy of Pediatrics, Committee on the Fetus and Newborn statement, \u201cmanagement of neonates with suspected or proven early-onset bacterial sepsis\u201d.","volume":"130","author":"Puopolo","year":"2012","journal-title":"Pediatrics"},{"key":"2021121015592971600_B26","article-title":"Polin RA. In reply, clinical report: management of neonates with suspected or proven early-onset bacterial sepsis.","volume":"130(4)","year":"2012","journal-title":"Pediatrics"},{"issue":"4","key":"2021121015592971600_B27","doi-asserted-by":"crossref","first-page":"F324","DOI":"10.1136\/adc.2004.066134","article-title":"Early onset neonatal meningitis in Australia and New Zealand, 1992-2002.","volume":"90","author":"May","year":"2005","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021121015592971600_B28","doi-asserted-by":"crossref","first-page":"198","DOI":"10.5694\/j.1326-5377.1995.tb126024.x","article-title":"Systemic bacterial and fungal infections in infants in Australian neonatal units.","volume":"162","author":"Isaacs","year":"1995","journal-title":"Med J Aust"},{"issue":"5","key":"2021121015592971600_B29","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1542\/peds.113.5.1181","article-title":"To tap or not to tap: high likelihood of meningitis without sepsis among very low birth weight infants.","volume":"113","author":"Stoll","year":"2004","journal-title":"Pediatrics"},{"issue":"6","key":"2021121015592971600_B30","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S0031-3955(05)70175-9","article-title":"Evaluation and management of infants with fever.","volume":"46","author":"Baker","year":"1999","journal-title":"Pediatr Clin North Am"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/6\/992\/919761\/peds_2013-2927.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/133\/6\/992\/919761\/peds_2013-2927.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T04:54:43Z","timestamp":1639198483000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/133\/6\/992\/76044\/Role-of-Guidelines-on-Length-of-Therapy-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,1]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2014,6,1]]},"published-print":{"date-parts":[[2014,6,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2013-2927","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,1]]}}}