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Abstract：
BACKGROUND: The risk of neonatal early-onset sepsis (EOS) is traditionally assessed on maternal signs of clinical chorioamnionitis. Recently, an online EOS risk calculator was developed by Kaiser Permanente using maternal and neonatal clinical parameters. We were interested in whether an increased Kaiser sepsis risk score correlates with histologic acute chorioamnionitis or acute funisitis.
METHODS: Included in this retrospective review are 119 chorioamnionitis-exposed term neonates from January 1, 2015 and December 31, 2016. Clinical charts from mother-baby pairs were reviewed. An EOS risk score was obtained using the online Kaiser Sepsis Calculator. The presence and severity of acute chorioamnionitis and acute funisitis were recorded. A SPSS software was used for statistical analysis (IBM, New Jersey, USA).
RESULTS: The Kaiser Sepsis Calculator could identify 97 of 119 (81.5%) neonates without increased risk for sepsis. Histologic acute chorioamnionitis was present in 100 of 119 cases (84%), in which 44 cases (44%) show severe acute chorioamnionitis. Acute funisitis was recognized in 87 of 119 (73.1%) cases, all of which had concurrent acute chorioamnionitis. Severe funisitis was seen in 38 of the 87 cases (43.7%). The Kaiser Sepsis risk score correlates with the presence and severity of acute funisitis (P = .037 and P = .044, respectively) but not with the presence or the severity of acute chorioamnionitis (P = .105 and P = .672, respectively).
CONCLUSIONS: Our study provides histological evidence to support that the Kaiser Sepsis Calculator may help to effectively reduce unwarranted blood culture, antibiotics exposure, and neonatal intensive care unit admission in term neonates.
METHODS: Included in this retrospective review are 119 chorioamnionitis-exposed term neonates from January 1, 2015 and December 31, 2016. Clinical charts from mother-baby pairs were reviewed. An EOS risk score was obtained using the online Kaiser Sepsis Calculator. The presence and severity of acute chorioamnionitis and acute funisitis were recorded. A SPSS software was used for statistical analysis (IBM, New Jersey, USA).
RESULTS: The Kaiser Sepsis Calculator could identify 97 of 119 (81.5%) neonates without increased risk for sepsis. Histologic acute chorioamnionitis was present in 100 of 119 cases (84%), in which 44 cases (44%) show severe acute chorioamnionitis. Acute funisitis was recognized in 87 of 119 (73.1%) cases, all of which had concurrent acute chorioamnionitis. Severe funisitis was seen in 38 of the 87 cases (43.7%). The Kaiser Sepsis risk score correlates with the presence and severity of acute funisitis (P = .037 and P = .044, respectively) but not with the presence or the severity of acute chorioamnionitis (P = .105 and P = .672, respectively).
CONCLUSIONS: Our study provides histological evidence to support that the Kaiser Sepsis Calculator may help to effectively reduce unwarranted blood culture, antibiotics exposure, and neonatal intensive care unit admission in term neonates.
摘要：
背景：新生儿早发性败血症（EOS）的风险传统上是根据临床绒毛膜羊膜炎的母体体征来评估的。最近,KaiserPermanente使用母体和新生儿临床参数开发了一种在线EOS风险计算器.我们对增加的Kaiser败血症风险评分是否与组织学急性绒毛膜羊膜炎或急性胃肠炎相关感兴趣。
方法：本回顾性综述包括2015年1月1日和2016年12月31日的119例绒毛膜羊膜炎暴露足月新生儿。回顾了母婴对的临床图表。使用在线Kaiser脓毒症计算器获得EOS风险评分。记录急性绒毛膜羊膜炎和急性真菌炎的存在和严重程度。使用SPSS软件进行统计分析(IBM，新泽西,美国）。
结果：Kaiser脓毒症计算器可以识别119名新生儿中的97名（81.5%），而没有增加脓毒症风险。119例中有100例（84%）出现组织学急性绒毛膜羊膜炎，其中44例（44％）表现为严重的急性绒毛膜羊膜炎。在119例病例中，有87例（73.1％）发现了急性胃肠炎，所有这些都并发急性绒毛膜羊膜炎。87例中有38例（43.7％）出现了严重的真菌炎。Kaiser脓毒症风险评分与急性绒毛膜羊膜炎的存在和严重程度相关（分别为P=.037和P=.044），但与急性绒毛膜羊膜炎的存在或严重程度无关（分别为P=.105和P=.672）。
结论：我们的研究提供了组织学证据，支持Kaiser脓毒症计算器可能有助于有效减少不必要的血培养，抗生素暴露，足月新生儿入住重症监护病房。
方法：本回顾性综述包括2015年1月1日和2016年12月31日的119例绒毛膜羊膜炎暴露足月新生儿。回顾了母婴对的临床图表。使用在线Kaiser脓毒症计算器获得EOS风险评分。记录急性绒毛膜羊膜炎和急性真菌炎的存在和严重程度。使用SPSS软件进行统计分析(IBM，新泽西,美国）。
结果：Kaiser脓毒症计算器可以识别119名新生儿中的97名（81.5%），而没有增加脓毒症风险。119例中有100例（84%）出现组织学急性绒毛膜羊膜炎，其中44例（44％）表现为严重的急性绒毛膜羊膜炎。在119例病例中，有87例（73.1％）发现了急性胃肠炎，所有这些都并发急性绒毛膜羊膜炎。87例中有38例（43.7％）出现了严重的真菌炎。Kaiser脓毒症风险评分与急性绒毛膜羊膜炎的存在和严重程度相关（分别为P=.037和P=.044），但与急性绒毛膜羊膜炎的存在或严重程度无关（分别为P=.105和P=.672）。
结论：我们的研究提供了组织学证据，支持Kaiser脓毒症计算器可能有助于有效减少不必要的血培养，抗生素暴露，足月新生儿入住重症监护病房。
