Abstract
Objetive: to determine the incidence of ENS in children born more than 24 hs. after PRM and to evaluate the diagnostic reliability of 3 tests alternative to blood culture namely culturing external auditive canal (EAC) swab, nasopharyngeal aspirate (NPA), gastric aspirate (GA).
Material and Methods: by a prospect we cross-sectional design, 146 newborns with PRM > 24 hs (91 females & 55males), born between September 1990 and May 1992, were studied. Blood culture was preformed within the first 3 hours of life and EAC, NPA and GA cultures and birth. ENS was considered present when clinical manifestations of sepsis were evident within the first 48 hs. and blood culture proved positive. Newborn from mothers on prior antibiotic therapy were excluded.
Results: ENS incidence in newborn from mothers with PRM ≥24 hs. was 16.4 (24/146), distributed as follows: 3.47 (5/146) associated to PRM alone without any other aggravating as factors; 6.2 (9/146) when PRM was associated to choriamnionitis; and 6.8% (10/146) with preterm birth. Islated Gram positive microorganisms were S. aureus (n=9), S. pneumo-niae (n=3), S. viridans (n=2), enterococcus (n=1), L. monocytogenes (n=1);Gram negative were K. pneumoniae (n=5), E. coli (n=2) and H. influenzae (n=1).
Conclusiones: * ENS incidence in children born later than 24 hs. following PRM confirmed by blood culture was 16.4.
None of the optional tests evaluated reached the required diagnostic reliability (sensivity plus specificity) to be employed ans an alternative test to blood culture for the diagnostic of ENS following PRM 24 hrs., but may be used as complementary methods for the evaluation of high risk newborn.
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Celadilla, M., Rosetti, F., Ochoa, L. et al. EARLY ONSET NEONATAL SEPSIS (ENS) FOLLOWING PREMATURE RUPTURE OF MEMBRANES (PRM) LATER THAN 24 HOURS: EVALUATION OF 3 ALTERNATIVE TESTS TO BLOOD CULTURE. Pediatr Res 36, 826 (1994). https://doi.org/10.1203/00006450-199412000-00041
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DOI: https://doi.org/10.1203/00006450-199412000-00041