{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:12:12Z","timestamp":1788048732337,"version":"build-2784847793"},"reference-count":70,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>Blood culture is the gold standard to diagnose bloodstream infection but is usually time-consuming. Prediction models aim to facilitate early preliminary diagnosis and treatment. We systematically reviewed prediction models for health care\u2013associated bloodstream infection (HABSI) in neonates, identified superior models, and pooled clinical predictors. Data sources: LibHub, PubMed, and Web of Science.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>The studies included designed prediction models for laboratory-confirmed HABSI or sepsis. The target population was a consecutive series of neonates with suspicion of sepsis hospitalized for \u226548 hours. Clinical predictors had to be recorded at time of or before culturing. Methodologic quality of the studies was assessed. Data extracted included population characteristics, total suspected and laboratory-confirmed episodes and definition, clinical parameter definitions and odds ratios, and diagnostic accuracy parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The systematic search revealed 9 articles with 12 prediction models representing 1295 suspected and 434 laboratory-confirmed sepsis episodes. Models exhibit moderate-good methodologic quality, large pretest probability range, and insufficient diagnostic accuracy. Random effects meta-analysis showed that lethargy, pallor\/mottling, total parenteral nutrition, lipid infusion, and postnatal corticosteroids were predictive for HABSI. Post hoc analysis with low-gestational-age neonates demonstrated that apnea\/bradycardia, lethargy, pallor\/mottling, and poor peripheral perfusion were predictive for HABSI. Limitations include clinical and statistical heterogeneity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Prediction models should be considered as guidance rather than an absolute indicator because they all have limited diagnostic accuracy. Lethargy and pallor and\/or mottling for all neonates as well as apnea and\/or bradycardia and poor peripheral perfusion for very low birth weight neonates are the most powerful clinical signs. However, the clinical context of the neonate should always be considered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-3226","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T00:32:23Z","timestamp":1425947543000},"page":"e1002-e1014","source":"Crossref","is-referenced-by-count":63,"title":["Prediction Models for Neonatal Health Care\u2013Associated Sepsis: A Meta-analysis"],"prefix":"10.1542","volume":"135","author":[{"given":"Evelien Hilde","family":"Verstraete","sequence":"first","affiliation":[{"name":"Ghent University, Belgium, Ghent, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Blot","sequence":"additional","affiliation":[{"name":"Ghent University, Belgium, Ghent, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludo","family":"Mahieu","sequence":"additional","affiliation":[{"name":"University of Antwerp, Belgium, Antwerp, Belgium;"},{"name":"Antwerp University Hospital, Antwerp, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Vogelaers","sequence":"additional","affiliation":[{"name":"Ghent University, Belgium, Ghent, Belgium;"},{"name":"Ghent University Hospital, Ghent, Belgium; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn","family":"Blot","sequence":"additional","affiliation":[{"name":"Ghent University, Belgium, Ghent, Belgium;"},{"name":"Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,4,1]]},"reference":[{"issue":"5","key":"2021120907063305600_B1","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1086\/675836","article-title":"Healthcare-associated bloodstream infections in a neonatal intensive care unit over a 20-year period (1992\u20132011): trends in incidence, pathogens, and mortality.","volume":"35","author":"Verstraete","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"2 pt 1","key":"2021120907063305600_B2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1542\/peds.110.2.285","article-title":"Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network.","volume":"110","author":"Stoll","year":"2002","journal-title":"Pediatrics"},{"issue":"1","key":"2021120907063305600_B3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/00006454-200001000-00012","article-title":"Occurrence of nosocomial bloodstream infections in six neonatal intensive care units.","volume":"19","author":"Brodie","year":"2000","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"2021120907063305600_B4","doi-asserted-by":"crossref","first-page":"F234","DOI":"10.1136\/adc.2010.206714","article-title":"Late onset bloodstream infections in a tertiary neonatal intensive care unit.","volume":"96","author":"Gupta","year":"2011","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"3","key":"2021120907063305600_B5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1053\/jhin.2000.0852","article-title":"Additional hospital stay and charges due to hospital-acquired infections in a neonatal intensive care unit.","volume":"47","author":"Mahieu","year":"2001","journal-title":"J Hosp Infect"},{"issue":"7","key":"2021120907063305600_B6","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/00006454-199807000-00004","article-title":"Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants.","volume":"17","author":"Fanaroff","year":"1998","journal-title":"Pediatr Infect Dis J"},{"issue":"19","key":"2021120907063305600_B7","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1001\/jama.292.19.2357","article-title":"Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection.","volume":"292","author":"Stoll","year":"2004","journal-title":"JAMA"},{"issue":"8","key":"2021120907063305600_B8","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1023\/A:1015665810739","article-title":"Neonatal late-onset bloodstream infection: attributable mortality, excess of length of stay and risk factors.","volume":"17","author":"Pessoa-Silva","year":"2001","journal-title":"Eur J Epidemiol"},{"issue":"6","key":"2021120907063305600_B9","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1053\/j.semperi.2012.06.009","article-title":"Long-term impact of infection on the preterm neonate.","volume":"36","author":"Adams-Chapman","year":"2012","journal-title":"Semin Perinatol"},{"issue":"4","key":"2021120907063305600_B10","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0146-0005(03)00046-6","article-title":"Infections in VLBW infants: studies from the NICHD Neonatal Research Network.","volume":"27","author":"Stoll","year":"2003","journal-title":"Semin Perinatol"},{"issue":"9","key":"2021120907063305600_B11","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1007\/s00431-004-1489-7","article-title":"A 7-year study of bloodstream infections in an English children\u2019s hospital.","volume":"163","author":"Gray","year":"2004","journal-title":"Eur J Pediatr"},{"issue":"5","key":"2021120907063305600_B12","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1097\/CCM.0b013e31819da98e","article-title":"Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients.","volume":"37","author":"Blot","year":"2009","journal-title":"Crit Care Med"},{"issue":"11\u201312","key":"2021120907063305600_B13","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s00103-012-1551-y","article-title":"Healthcare-associated infection rates: measuring and comparing. 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