Neonatal early-onset infections: Comparing the sensitivity of the neonatal early-onset sepsis calculator to the Dutch and the updated NICE guidelines in an observational cohort of culture-positive cases

• Published in: EClinicalMedicine 2022-02, Vol.44, p.101270-101270, Article 101270
• Main Authors: Snoek, Linde, van Kassel, Merel N., Krommenhoek, Jurjen F., Achten, Niek B., Plötz, Frans B., van Sorge, Nina M., Brouwer, Matthijs C., van de Beek, Diederik, Bijlsma, Merijn W.
• Format: Article
• Language: English
• Subjects: cohort study; early-onset disease (EOD); EOS calculator; meningitis; neonates; newborns; sepsis; sepsis calculator
• ISSN: 2589-5370; 2589-5370
• DOI: 10.1016/j.eclinm.2021.101270

The early-onset sepsis calculator (EOSC) reduces unnecessary antibiotic treatment in newborns. However, its performance in identifying cases with early-onset disease (EOD) is unclear. We compared the sensitivity of the EOSC to the current Dutch and National Institute for Health and Care Excellence (NICE) guidelines when applied to a cohort of newborns with culture-positive early-onset sepsis and meningitis. Culture-positive Streptococcus agalactiae (GBS) and Escherichia coli (E. coli) sepsis and meningitis patients ≤3 days old with a gestational age ≥34 weeks, identified between 1/1/2018 and 31/1/2021 in a Dutch prospective nationwide cohort study were included. Cases were identified by treating physicians and microbiological surveillance. Primary outcome was the proportion of patients that would have been treated according to the EOSC, the Dutch, and the NICE EOD prevention guidelines. Differences between proportions were analysed using McNemar's test. We included 81 GBS and 7 E. coli EOD cases. At 4 h after birth, the EOSC would have recommended antibiotic treatment in 32 (36%) patients, compared to 44 (50%) by the Dutch (p