Author(s): Hofer N, Zacharias E, Mller W, Resch B
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Abstract AIMS: The aim of this study was to examine the applicability of the definitions of the systemic inflammatory response syndrome (SIRS) and sepsis to neonates during the first 3 days of life. METHODS: This is a retrospective study of all term neonates hospitalized within the first 24 h of life from 2004 to 2010 at our neonatal intensive care unit. RESULTS: Of 476 neonates, 30 (6 \%) had a diagnosis of culture-proven early-onset sepsis (EOS) and 81 (17 \%) had culture-negative clinical EOS or suspected EOS. SIRS and sepsis criteria were applied to 116 (24 \%) and 61 (13 \%) neonates, respectively. Of 30 neonates with culture proven, EOS 14 (53 \%) fulfilled SIRS and sepsis criteria. The single diagnostic criterion of SIRS applied to 20 \% (hypothermia or fever), 43 \% (white blood cell count/immature-to-total neutrophil ratio), 87 \% (respiratory symptoms), and 33 \% (cardiocirculatory symptoms) of all neonates with culture-proven EOS. CONCLUSIONS: The definitions of SIRS and sepsis did not apply to about half of all cases of culture-proven EOS. An evidence-based approach to find the appropriate criteria for defining EOS in the neonate is needed.
This article was published in J Perinat Med
and referenced in Journal of Neonatal Biology