1. Comparison of diagnoses of early-onset sepsis associated with use of Sepsis Risk Calculator versus NICE CG149: a prospective, population-wide cohort study in London, UK, 2020–2021
- Author
-
Kirsty Le Doare, Justin Richards, Paul T Heath, Justinas Teiserskas, Natasha Liow, Helen Smith, Ramnik Mathur, Ruth Shephard, Richard Nicholl, Nandiran Ratnavel, Elizabeth Eyre, Caroline Sullivan, Rie Yoshida, Maria Mendoza, Ambalika Das, Catherine Longley, Andrew Chapman, Shu-Ling Chuang, Sarah May Johnson, Christina Kortsalioudaki, Cheryl Battersby, Amit Verma, Catherine Douch, Keya Sahay, Neha Sharma, Igor Fierens, Tristan Bate, Yinru Lim, Chris Harris, Kate Ryan, Cheentan Singh, Hannah Walker, Alicia Demirjian, Theresa Lamagni, Mariam Elbakry, Neaha Patel, Giles Kendall, Ozioma Obi, Eleanor Hulse, Chloe Ann Cheang, Matthew Rubens, Katie Evans, Kazim Ghafoor, George Lawson, John Ho, Nichola Monks, Lidia Tyszczuk, Chinthika Piyasena, Anne Opute, Zainab Kassim, Sara Tho-Calvi, Erica Twum-Barimah, Divyen Shah, Sara Abdulla, Stephanie Tolan, Sophia Teoh, Siddhartha Paliwal, Uma Srirambhatla, Lucy Crossman, Rebecca Gaunt, Devangi Thakkar, Saranya Ravindran, Sara Farhat Dominguez, Sunanda Bhatia, Joana Freitas, Clare Cane, Ramyia Elangovan, Cassandra Gyamtso, Helen Nightingale, Angela De Cunto, Eleanor Duckworth, Clare Middleton, Lauren Ferretti, Catherine Warrick, Harshini Naidu, Daniel Geer, Nilmi Ekanayake, Lukas Huhn, Rita Marciano, Shivani Shah, Sonia Spathis, Jonathan Filkin, Mohammad Alam, Khadija Ben-Sasi, Julia Croft, Suzanne Sweeney, Reshmi Raychaudhuri, Evangelia Myttaraki, Ayesha Rahim, Sorana Galu, Joanna O'Sullivan, Jenni Jagodzinski, Remon Agaibi, Elmunzir Ahmed, Luvena Anthony, Luana Ayres da Silva, Nauman Balghari, Archana Bansal, Alexandra Briscoe, Sabina Checketts, Jagadish Chintapalli, Li Yan Chow, Jonathan Cookson, Daniel Crane, Andrew DeSilva, Stacey De Atougia, Mariana Gaspar Fonseca, Adeoya Gbemiga Olabamiji, Nicola Glogowski, Andrea Gronska, Jennifer Ho, Nichola Hodges, Ola Joseph, Keisha Kamalanathan, Jessica Kimpton, Niamh Langasco, Rosalie Lear, Amanda Moules, Rajvi Nagrecha, Noor Nusair, Chisaraokwu Nwachukwu, Felicity Ockelford, Chineze Okorowo, Yujing Ooi, Evgenia Panagiotopoulou, Nadia Saleem, Miriam Sanderson, Mashal Shamsuddin, Ana Silva Ferreira, Srikanthy Sivakanthan, Devika Thakur, Naomi Tobi, Madduka Umeh, Benjamin Ummat, Rebecca Unwin, Aarti Verma, Rebecca Wesson, Adelene Wong, Zijian (Chris) Zhang, Juliet Banya, Eleanor Bond, Rina Chotai, Hayley Clements, Alka Desai, Simon Drysdale, Lydia Eze, Laura Govender, Sophie Griffiths, Michela Groppo, Gopinathannair Harikumar, Linda Machakaire, Joselyn Morris, Amisha Singh, Maria Symeonaki, Mercy Ughwujabo, Kirsty Watts, Louis Yee, and Jenny Ziprin
- Subjects
Medicine - Abstract
Objective We sought to compare the incidence of early-onset sepsis (EOS) in infants ≥34 weeks’ gestation identified >24 hours after birth, in hospitals using the Kaiser Permanente Sepsis Risk Calculator (SRC) with hospitals using the National Institute for Health and Care Excellence (NICE) guidance.Design and setting Prospective observational population-wide cohort study involving all 26 hospitals with neonatal units colocated with maternity services across London (10 using SRC, 16 using NICE).Participants All live births ≥34 weeks’ gestation between September 2020 and August 2021.Outcome measures EOS was defined as isolation of a bacterial pathogen in the blood or cerebrospinal fluid (CSF) culture from birth to 7 days of age. We evaluated the incidence of EOS identified by culture obtained >24 hours to 7 days after birth. We also evaluated the rate empiric antibiotics were commenced >24 hours to 7 days after birth, for a duration of ≥5 days, with negative blood or CSF cultures.Results Of 99 683 live births, 42 952 (43%) were born in SRC hospitals and 56 731 (57%) in NICE hospitals. The overall incidence of EOS (24 hours was 2.3/100 000 (n=1) for SRC vs 7.1/100 000 (n=4) for NICE (OR 0.5, 95% CI (0.1 to 2.7)). This corresponded to (1/20) 5% (SRC) vs (4/45) 8.9% (NICE) of EOS cases (χ=0.3, p=0.59). Empiric antibiotics were commenced >24 hours to 7 days after birth in 4.4/1000 (n=187) for SRC vs 2.9/1000 (n=158) for NICE (OR 1.5, 95% CI (1.2 to 1.9)). 3111 (7%) infants received antibiotics in the first 24 hours in SRC hospitals vs 8428 (15%) in NICE hospitals.Conclusion There was no significant difference in the incidence of EOS identified >24 hours after birth between SRC and NICE hospitals. SRC use was associated with 50% fewer infants receiving antibiotics in the first 24 hours of life.
- Published
- 2023
- Full Text
- View/download PDF