GP205 Maternal pyrexia at birth; a true neonatal infection or not?

Background Early onset neonatal sepsis(EOS) is defined as infection in the first 72hours of life1. It can cause serious morbidity and mortality therefore prophylactic antibiotics are required for high risk infants.1 Objective To determine the rate of positive blood cultures in babies treated in view of maternal pyrexia. To compare maternal high CRP and blood cultures with babies CRP and blood cultures. Standard NICE guidelines Neonatal infection (early onset): antibiotics for prevention and treatment published: 22 August 2012.2 Methods Retrospective chart review was done on term babies admitted to NICU with maternal pyrexia form July 2016 to December 2016. Details of babies blood culture, CRP, and further workup e.g CSF studies and PCR studies were collected. Other details of maternal septic workup were also recorded. Data was compiled on Microsoft excel sheet and results analyzed. Results Total 52 babies admitted from July 2016 to December 2016 in NICU with suspected EOS. 31%(n=16) have other risk factors for EOS like maternal GBS, chorioamnionitis or PROM were excluded from the study. Only 3%(n=1) blood culture came back Micrococcus Luteus positive(contamination) with negative maternal culture. None of the mother involved in this study had positive blood culture. 28%(n=10) of the babies had CRP in the range of 6 to 30 mg/L while 3%(n=1) of the babies had CRP above 50 mg/L. 59%(n=20) of the maternal CRP were less than 50 mg/L. Only 6%(n=2) of the mothers had CRP more than 200 mg/L compared to babies CRP less than 5 mg/L. Conclusion No correlation between baby CRP and maternal CRP in view of maternal pyrexia. None of the babies had positive blood culture in this cohort. Treating babies in view of maternal pyrexia alone as the risk factor for EOS should be reviewed to restrict unnecessary antibiotics use. References Emily J. Weston, MPH, Tracy Pondo, MSPH, Melissa M. Lewis, MPH, Pat Martell-Cleary, MSW: The Burden of Invasive Early-Onset Neonatal Sepsis in the United States 2005–2008Pediatr Infect Dis J. 2011 Nov; 30(11): 937–941 NICE guidelines: Neonatal infection(early onset): antibiotics for prevention and treatment(CG149); August 2012