Puopolo et al identified maternal factors which can help to identify an extremely premature neonate who is at low risk for early-onset neonatal sepsis (EONS). A neonate at low risk for EONS may not require antibiotic therapy. The authors are from the NICHD Neonatal Research Network and multiple institutions in the United States.
Patient selection: 22 to 28 weeks gestation
Outcome: early-onset neonatal sepsis
Criteria for early-onset neonatal sepsis:
(1) onset at age <= 72 hours
(2) one or more of the following:
(2a) blood or cerebrospinal cultures positive for a pathogenic bacteria
(2b) blood or cerebrospinal culture positive for yeast or fungus
(2c) antibiotic therapy for >= 5 days
(2d) intent to treat with antibiotics and death at age < 5 days
The reason for premature delivery in the low risk group relates to maternal health issues,.
Predictors of low risk for early-onset neonatal sepsis - all of the following:
(1) delivery by cesarean section
(2) rupture of membranes at delivery (intact prior to)
(3) no evidence of maternal chorioamnionitis
Presumably the neonate shows normal development and is free of problems other than the prematurity.
