早发性败血症:临床观察还是危险因素分析?

IF 2.8 4区 医学 Q1 PEDIATRICS Jornal de pediatria Pub Date : 2024-11-30 DOI:10.1016/j.jped.2024.10.007
Sofia Romay Oliveira, Cintia Lopes, Alana Beatriz Coelho Basilio
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引用次数: 0

摘要

目的:比较基于分类风险分层的早发性脓毒症(EOS)围产期危险因素方法与基于临床观察的方法,评估其对实验室检测频率、抗生素治疗使用和EOS发生率的影响。方法:回顾性观察研究,于2021年11月至2022年3月进行。纳入34周龄新生儿(NB),并评估产前护理、出生、住院和实验室检查的临床数据。结果:样本1086例新生儿。临床观察法有97名新生儿(8.9 %)接受了感染筛查,围产期危险因素法有279名新生儿(26.5% %)接受了感染筛查,与围产期危险因素法相比,临床观察法减少了65.2% % (p )结论:与围产期危险因素法相比,临床观察法减少了实验室检查和抗生素治疗的使用,对EOS的发生率没有影响。需要进一步的研究来确定系统化NB系列检查的最佳方法,以及哪些症状是EOS的最佳预测因子。
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Early onset sepsis: clinical observation or risk factors approach?

Objectives: To compare the perinatal risk factors approach for early-onset sepsis (EOS), which is based on categorical risk stratification, with the clinical observation-based approach, evaluating their impact on laboratory testing frequency, the use of antibiotic therapy, and EOS incidence.

Methods: Retrospective observational study, conducted from November 2021 to March 2022. Newborns (NB) at 34 wk of age were included and clinical data from prenatal care, birth, hospitalization, and laboratory tests were evaluated.

Results: Sample of 1,086 newborns. Ninety-seven NB (8.9 %) underwent infectious screening in the clinical observation approach versus 279 (26.5 %) in the perinatal risk factors approach, which represents a 65.2 % decrease in the clinical observation approach (p < 0.01). Under the perinatal risk factors approach, 35 (3.2 %) of NBs received empirical antibiotic therapy for EOS, versus only 22 (2.0 %) in the clinical observation approach, which would be a 37.1 % decrease in the clinical observation strategy (p < 0.01). We found no difference in the incidence of culture-confirmed EOS.

Conclusion: The clinical observation approach, when compared to the perinatal risk factors approach, reduces laboratory testing and the use of antibiotic therapy, with no impact on the incidence of EOS. Further research is required to determine the best way to systematize serial examinations of NB's and which symptoms would be the best predictors of EOS.

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来源期刊
Jornal de pediatria
Jornal de pediatria 医学-小儿科
CiteScore
5.60
自引率
3.00%
发文量
93
审稿时长
43 days
期刊介绍: Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.
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