Abstract
OBJECTIVE: To establish the appropriate length of antibiotic therapy for negative late-onset sepsis evaluations in the neonatal intensive care unit (NICU), based on time to detection of positive bacterial cultures.
STUDY DESIGN: Culture results from late-onset sepsis evaluations between January 1, 1994 and June 30, 1998 from outborn neonates at the Arkansas Children's Hospital NICU were retrospectively reviewed. The time period from specimen collection to notification of NICU personnel was calculated for positive cultures.
RESULTS: There were 2783 blood, 724 urine, and 294 cerebrospinal fluid cultures obtained, of which 10.2%, 6.6%, and 5.4%, respectively, were positive for bacterial isolates. Of positive cultures, 98% had a time to detection ≤48 hours. Of cultures that became positive >48 hours, 7 of 8 grew coagulase-negative staphylococci; 4 were contaminants.
CONCLUSION: Discontinuing antibiotic therapy for neonates with possible late-onset sepsis and negative cultures at 48 hours is appropriate and is now standard care in our NICU.
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References
Pichichero ME, Todd JK . Detection of neonatal bacteremia J Pediatr 1979 94: 958–60
Rowley AH, Wald ER . Incubation period necessary to detect bacteremia in neonates Pediatr Infect Dis 1986 5: 590–1
Hurst MK, Yoder BA . Detection of bacteremia in young infants: is 48 hours adequate? Pediatr Infect Dis J 1995 14: 711–2
Philip AGS . The changing face of neonatal infection: experience at a regional medical center Pediatr Infect Dis J 1994 13: 1098–102
Stoll BJ, Gordon T, Korones SB et al. Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network J Pediatr 1996 129: 63–71
Wiswell TE, Baumgart S, Gannon CM, Spitzer AR . No lumbar puncture in the evaluation for early neonatal sepsis: will meningitis be missed? Pediatrics 1995 95: 803–6
Weese-Mayer DE, Fondriest DW, Brouillette RT, Shulman ST . Risk factors associated with candidemia in the neonatal intensive care unit: a case–control study Pediatr Infect Dis J 1987 6: 190–6
Acknowledgements
We thank Janet Kooshesh, Information Systems, Arkansas Children's Hospital, for her technical assistance, and Jerry B. Gee II, MD, and Richard F. Jacobs, MD, for review of the manuscript.
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Kaiser, J., Cassat, J. & Lewno, M. Should Antibiotics be Discontinued at 48 Hours for Negative Late-Onset Sepsis Evaluations in the Neonatal Intensive Care Unit?. J Perinatol 22, 445–447 (2002). https://doi.org/10.1038/sj.jp.7210764
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DOI: https://doi.org/10.1038/sj.jp.7210764
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