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Objective The study aimed to evaluate the validity of transcutaneous bilirubin (TcB) measurements at three sites in premature infants born at 23 0/7 to 34 6/7 weeks' gestational age (GA) compared with total serum bilirubin (TSB) measurements. Study Design A prospective study was conducted at Banner – University Medical Center Phoenix, where informed consent was obtained from the infant's parent or legally authorized representative. Cohort A was comprised of infants 23 0/7 to 28 6/7 weeks' GA and Cohort B contained subjects 29 0/7 to 34 6/7 weeks' GA. Baseline TSB measurements were collected at approximately 24 hours of life, as the standard of care and the TcB measurements were obtained from the sternum, interscapular, and buttock areas at approximately ± 30 minutes from collection of the TSB. Statistical analysis of measurements including sensitivity, specificity, positive, and negative predictive values, and the area under the receiver operator characteristic curve (AUROC) were performed. Results A total of 166 infants were included in the study population. Cohort A consisted of 41 subjects and Cohort B contained 125 subjects. The results showed that baseline TcB measurements from the interscapular area were the most sensitive and specific with TSB levels >5.0 mg/dL in Cohort A. Baseline TcB measurements from the sternum demonstrated greatest sensitivity and specificity when the TSB level was >8.0 mg/dL in Cohort B. In general, each of the three sites in both cohorts demonstrated excellent AUROCs and negative predictive values. Conclusion The use of a TcB meter in preterm infants can be a reliable noninvasive screening tool for hyperbilirubinemia, and it may be beneficial in decreasing painful stimuli and iatrogenic blood loss when used as an adjunct to TSB monitoring. Key Points Interscapular TcB is sensitive/specific in 23 to 29 weeks' GA. Sternal TcB is sensitive/specific in 29 to 35 weeks' GA. TcB readings are reliable in preterm infants. TcB is reliable when serum bilirubin is >5.0 mg/dL. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is a serious condition caused largely by group B Streptococcus (GBS), Escherichia coli (E. Coli), and Listeria monocytogenes. Prenatal screenings have decreased the incidence of GBS infections; however, it remains a leading cause of early-onset sepsis (EOS). Gram-positive organisms are often the cause of late-onset sepsis (LOS). While EOS is usually attributed to vertical transmission from mother to infant, LOS is secondary to pathogen exposure during delivery or hospi-talization. We sought to identify the prevalent organisms in positive blood cultures in our NICU. Methods: A retrospective chart review was completed from July 2009 to December 2019. If an organism was identified, a positive culture was included, and five or more days of antibiotics were administered. Infection occurring in the first three days of life was considered EOS, while LOS was any time after. Variables were evaluated using Fisher's exact and Wilcoxon rank-sum tests. Results: Over ten years, there were 89 positive blood cultures. Of these, 28% of the cases were EOS, and 72% were LOS. Interestingly, the median birth weight for infants with EOS was significantly larger at 1810g compared to 1021g for LOS (P=0.004). The median gestational age for EOS cases was 31 5/7 weeks compared to 27 2/7 weeks for LOS (P=0.086). Conclusions: Approximately half of EOS-causing organisms were GBS or E.Coli. Coagulase-negative staphylococcus and methicillin-susceptible Staphylococcus aureus were most prevalent in LOS. [ABSTRACT FROM AUTHOR]