463 - Efficacy of the Kaiser Sepsis Calculator in Reducing Antibiotic Use in Infants with Intrauterine Opioid Exposure
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 463 Publication Number: 463.432
Zachary J.. Emmons, University of New Mexico School of Medicine, Albuquerque, NM, United States; Lu-ann Papile, UNM Health Sciences Center, Albuquerque, NM, United States; Janell Fuller, University of New Mexico School of Medicine, Albuquerque, NM, United States
Neonatal-Perinatal Medicine Fellow University of New Mexico School of Medicine Albuquerque, New Mexico, United States
Background: Early-onset sepsis (EOS) cannot be reliably detected with any one laboratory study or clinical sign. The Kaiser Early-Onset Sepsis Calculator (SRC) is a predictive model for estimating EOS risk in neonates ≥ 34 weeks of gestation (GA). The population used in developing the SRC consisted of infants ≥ 34 weeks (GA), excluding those with congenital anomalies. Signs of withdrawal from intrauterine opioid exposure (IUOE) are similar to those seen in EOS. Whether this might affect the utility of the SRC as an evaluation tool is unknown. Objective: Our aims were: 1) to determine the frequency of laboratory evaluation or empiric antibiotic therapy, despite the SRC recommendations against such interventions, among infants ≥36 weeks GA with IUOE and 2) to compare compliance with SRC recommendations among infants ≥36 weeks GA with IUOE to that of a comparable group of infants without IUOE. Design/Methods: The population studied was infants admitted to the UNMH newborn nursery (≥ 36 weeks GA and routinely screened with SRC) from 6/1/2019 to 12/31/2019. Medical record data regarding SRC score, SRC recommendations, and the frequency of sepsis evaluations and empiric antibiotic treatment, were entered into a secure Research Electronic Data Capture (REDCap™) database. Infants with documented IUOE exposure were matched 1:2 with a similar group of infants without IUOE. Data were analyzed using IBM SPSS™ software. Results: 49 infants with IUOE meeting inclusion criteria were identified; no matches or only one match were identified for 5 infants. 44 were matched 1:2 to 88 infants without IUOE for gestational age at birth, sex, delivery mode, and LGA, SGA, or AGA status. Further data regarding inclusion and exclusion of infants is shown in Figure 1. Mean SRC-estimated EOS risk scores and laboratory results for the two groups are compared in Table 1. The number of infants in each group for whom blood cultures were obtained and who received antibiotics are listed in Table 2, as are the number of infants for whom management differed from SRC recommendations.
Conclusion(s): There were no significant differences between the groups in the number of infants for whom the SRC recommended blood culture or antibiotic therapy, or who underwent a blood culture or received empiric antibiotics despite SRC recommendations.
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