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dc.contributor.authorKlingenberg, Claus
dc.contributor.authorKornelisse, Rene F.
dc.contributor.authorBuonocore, Giuseppe
dc.contributor.authorMaier, Rolf F.
dc.contributor.authorStocker, Martin
dc.date.accessioned2019-03-07T11:02:43Z
dc.date.available2019-03-07T11:02:43Z
dc.date.issued2018-10-09
dc.description.abstractSepsis is a leading cause of mortality and morbidity in neonates. Presenting clinical symptoms are unspecific. Sensitivity and positive predictive value of biomarkers at onset of symptoms are suboptimal. Clinical suspicion therefore frequently leads to empirical antibiotic therapy in uninfected infants. The incidence of culture confirmed early-onset sepsis is rather low, around 0.4–0.8/1000 term infants in high-income countries. Six to 16 times more infants receive therapy for culture-negative sepsis in the absence of a positive blood culture. Thus, culture-negative sepsis contributes to high antibiotic consumption in neonatal units. Antibiotics may be life-saving for the few infants who are truly infected. However, overuse of broad-spectrum antibiotics increases colonization with antibiotic resistant bacteria. Antibiotic therapy also induces perturbations of the non-resilient early life microbiota with potentially long lasting negative impact on the individual‘s own health. Currently there is no uniform consensus definition for neonatal sepsis. This leads to variations in management. Two factors may reduce the number of culture-negative sepsis cases. First, obtaining adequate blood cultures (0.5–1 mL) at symptom onset is mandatory. Unless there is a strong clinical or biochemical indication to prolong antibiotics physician need to trust the culture results and to stop antibiotics for suspected sepsis within 36–48 h. Secondly, an international robust and pragmatic neonatal sepsis definition is urgently needed. Neonatal sepsis is a dynamic condition. Rigorous evaluation of clinical symptoms (“organ dysfunction”) over 36–48 h in combination with appropriately selected biomarkers (“dysregulated host response”) may be used to support or refute a sepsis diagnosis.en_US
dc.descriptionThe following article, Klingenberg, C., Kornelisse, R.F., Buonocore, G., Maier, R.F. & Stocker, M. (2018). Culture-negative early-onset neonatal sepsis - at the crossroad between efficient sepsis care and antimicrobial stewardship. <i>Frontiers in pediatrics, 6</i>, 285, can be accessed at <a href=https://doi.org/10.3389/fped.2018.00285> https://doi.org/10.3389/fped.2018.00285</a>.en_US
dc.identifier.citationKlingenberg, C., Kornelisse, R.F., Buonocore, G., Maier, R.F. & Stocker, M. (2018). Culture-negative early-onset neonatal sepsis - at the crossroad between efficient sepsis care and antimicrobial stewardship. <i>Frontiers in pediatrics, 6</i>, 285. https://doi.org/10.3389/fped.2018.00285en_US
dc.identifier.cristinIDFRIDAID 1637829
dc.identifier.doi10.3389/fped.2018.00285
dc.identifier.issn2296-2360
dc.identifier.urihttps://hdl.handle.net/10037/14886
dc.language.isoengen_US
dc.publisherFrontiers Mediaen_US
dc.relation.journalFrontiers in pediatrics
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Pediatrics: 760en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Pediatri: 760en_US
dc.subjectneonateen_US
dc.subjectsepsisen_US
dc.subjectblood cultureen_US
dc.subjectC-reactive proteinen_US
dc.subjectprocalcitoninen_US
dc.titleCulture-negative early-onset neonatal sepsis - at the crossroad between efficient sepsis care and antimicrobial stewardshipen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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