Impact of neonatal sepsis calculator in West Midlands (UK)

Tim J van Hasselt; Helen McDermott; Pinki  Surana; Rawia  Eltahir; Laura  Macaskill; Raunak  Jain; Nicola  McMullan; Samantha  Slee; Megha  Jagga; Muhammed  Naseem; Oluwaseyi  Alake; Canada  Cherry; Benjamin  Miguras; Andrew Ewer

doi:10.1136/archdischild-2020-320862

Impact of neonatal sepsis calculator in West Midlands (UK)

Tim J van Hasselt, Helen McDermott, Pinki Surana, Rawia Eltahir, Laura Macaskill, Raunak Jain, Nicola McMullan, Samantha Slee, Megha Jagga, Muhammed Naseem, Oluwaseyi Alake, Canada Cherry, Benjamin Miguras, Andrew Ewer

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Abstract

The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) was developed to predict early-onset neonatal sepsis (EOS), using continuous variables (local EOS incidence rates, maternal factors, infant well-being) to guide decision making.1

KP-SRC has been adopted in Plymouth and Wales, reducing antibiotic use by up to 84%2 3 compared with using National Institute for Health and Care Excellence (NICE) guidelines. This may reduce antibiotic resistance, dysbiosis,2 invasive procedures and mother–baby separation, although some safety concerns have been raised.4

We performed a virtual application of the KP-SRC versus NICE guidance on postnatal antibiotic usage and length of stay, using anonymised clinical data collected prospectively across 11 neonatal units in the West Midlands, UK. The Health Research Authority confirmed ethical approval was not required.

All infants born ≥34 weeks’ gestation between 1 January 2020 and 29 February 2020 who were commenced on antibiotics for EOS and managed as per NICE guidelines were included. Those admitted to the neonatal unit prior to commencing antibiotics were excluded.

The KP-SRC was applied retrospectively, using two EOS incidence rates—1/1000 and 2/1000 live births (West Midlands rate varies between 0.7 and 1.3/1000). KP-SRC recommendations were analysed against evidence of EOS.

Data from 626 infants were collected and 599 were included for analysis (figure 1).

Original language	English
Article number	archdischild-2020-320862
Journal	Archives of disease in childhood. Fetal and neonatal edition
Early online date	8 Dec 2020
DOIs	https://doi.org/10.1136/archdischild-2020-320862
Publication status	E-pub ahead of print - 8 Dec 2020

Keywords

microbiology
neonatology

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynaecology

Access to Document

10.1136/archdischild-2020-320862Licence: None: All rights reserved

vanHasseltT2020Impact
This document is the Author Accepted Manuscript version of a published work which appears in its final form in Archives of Disease in Childhood - Fetal and Neonatal Edition, copyright © Author(s) (or their employer(s)) 2020. No commercial re-use. The final Version of Record can be found at: http://dx.doi.org/10.1136/archdischild-2020-320862
Accepted author manuscript, 299 KBLicence: Creative Commons: Attribution-NonCommercial (CC BY-NC)

Cite this

van Hasselt, T. J., McDermott, H., Surana, P., Eltahir, R., Macaskill, L., Jain, R., McMullan, N., Slee, S., Jagga, M., Naseem, M., Alake, O., Cherry, C., Miguras, B., & Ewer, A. (2020). Impact of neonatal sepsis calculator in West Midlands (UK). Archives of disease in childhood. Fetal and neonatal edition, Article archdischild-2020-320862. Advance online publication. https://doi.org/10.1136/archdischild-2020-320862

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abstract = "The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) was developed to predict early-onset neonatal sepsis (EOS), using continuous variables (local EOS incidence rates, maternal factors, infant well-being) to guide decision making.1KP-SRC has been adopted in Plymouth and Wales, reducing antibiotic use by up to 84%2 3 compared with using National Institute for Health and Care Excellence (NICE) guidelines. This may reduce antibiotic resistance, dysbiosis,2 invasive procedures and mother–baby separation, although some safety concerns have been raised.4We performed a virtual application of the KP-SRC versus NICE guidance on postnatal antibiotic usage and length of stay, using anonymised clinical data collected prospectively across 11 neonatal units in the West Midlands, UK. The Health Research Authority confirmed ethical approval was not required.All infants born ≥34 weeks{\textquoteright} gestation between 1 January 2020 and 29 February 2020 who were commenced on antibiotics for EOS and managed as per NICE guidelines were included. Those admitted to the neonatal unit prior to commencing antibiotics were excluded.The KP-SRC was applied retrospectively, using two EOS incidence rates—1/1000 and 2/1000 live births (West Midlands rate varies between 0.7 and 1.3/1000). KP-SRC recommendations were analysed against evidence of EOS.Data from 626 infants were collected and 599 were included for analysis (figure 1).",

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AB - The Kaiser Permanente Sepsis Risk Calculator (KP-SRC) was developed to predict early-onset neonatal sepsis (EOS), using continuous variables (local EOS incidence rates, maternal factors, infant well-being) to guide decision making.1KP-SRC has been adopted in Plymouth and Wales, reducing antibiotic use by up to 84%2 3 compared with using National Institute for Health and Care Excellence (NICE) guidelines. This may reduce antibiotic resistance, dysbiosis,2 invasive procedures and mother–baby separation, although some safety concerns have been raised.4We performed a virtual application of the KP-SRC versus NICE guidance on postnatal antibiotic usage and length of stay, using anonymised clinical data collected prospectively across 11 neonatal units in the West Midlands, UK. The Health Research Authority confirmed ethical approval was not required.All infants born ≥34 weeks’ gestation between 1 January 2020 and 29 February 2020 who were commenced on antibiotics for EOS and managed as per NICE guidelines were included. Those admitted to the neonatal unit prior to commencing antibiotics were excluded.The KP-SRC was applied retrospectively, using two EOS incidence rates—1/1000 and 2/1000 live births (West Midlands rate varies between 0.7 and 1.3/1000). KP-SRC recommendations were analysed against evidence of EOS.Data from 626 infants were collected and 599 were included for analysis (figure 1).

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Impact of neonatal sepsis calculator in West Midlands (UK)

Abstract

Keywords

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