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Neonates presenting with temperature symptoms: Role in the diagnosis of early onset sepsis
Author(s) -
Hofer Nora,
Müller Wilhelm,
Resch Bernhard
Publication year - 2012
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03570.x
Subject(s) - medicine , hypothermia , sepsis , neonatal intensive care unit , pneumonia , pediatrics , chorioamnionitis , retrospective cohort study , gestational age , pregnancy , biology , genetics
Background: In this study, we aimed to evaluate the role of fever, hypothermia, and temperature instability in term and preterm newborns during the first 3 days of life and to identify risk factors for early onset sepsis (EOS) among newborns presenting with these temperature symptoms. Methods: In this retrospective cohort study set in our level III neonatal intensive care unit, we included all newborns hospitalized within the first 24 h of life from 2004 to 2007. Results: Of 851 newborns, 127 presented with temperature symptoms during the first 3 days of life (15%): 69 had fever, 69 had hypothermia, and 55 had temperature instability (8%, 8%, and 6%, respectively). Of 127 newborns presenting with temperature symptoms, 14 had culture‐proven EOS/pneumonia (33% of all 42 newborns with culture‐proven EOS/pneumonia), 67 had clinical EOS (30% of all 209 newborns with clinical EOS) and 46 were EOS‐negative (8% of all 600 EOS‐negatives). Factors associated with culture‐proven EOS/pneumonia in newborns presenting with temperature symptoms were maternal fever ( P = 0.009), chorioamnionitis ( P < 0.001), antibiotic therapy of the mother ( P = 0.04), poor skin color ( P = 0.001) and syndrome of persistent fetal circulation ( P = 0.01). Conclusions: Every seventh newborn hospitalized at our neonatal intensive care unit developed fever, hypothermia and/or temperature instability during the first 3 days of life. Two‐thirds of them had culture‐proven or clinical sepsis. Temperature symptoms were rarely observed in EOS‐negative newborns (8%) but despite low sensitivity, were highly specific for bacterial infection in preterm and term newborns.