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2016 ; 28
(2
): 135-40
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Defining neonatal sepsis
#MMPMID26766602
Wynn JL
Curr Opin Pediatr
2016[Apr]; 28
(2
): 135-40
PMID26766602
show ga
PURPOSE OF REVIEW: Although infection rates have modestly decreased in the
neonatal intensive care unit (NICU) as a result of ongoing quality improvement
measures, neonatal sepsis remains a frequent and devastating problem among
hospitalized preterm neonates. Despite multiple attempts to address this unmet
need, there have been minimal advances in clinical management, outcomes, and
accuracy of diagnostic testing options over the last 3 decades. One strong
contributor to a lack of medical progress is a variable case definition of
disease. The inability to agree on a precise definition greatly reduces the
likelihood of aligning findings from epidemiologists, clinicians, and
researchers, which, in turn, severely hinders progress toward improving outcomes.
RECENT FINDINGS: Pediatric consensus definitions for sepsis are not accurate in
term infants and are not appropriate for preterm infants. In contrast to the
defined multistage criteria for other devastating diseases encountered in the
NICU (e.g., bronchopulmonary dysplasia), there is significant variability in the
criteria used by investigators to substantiate the diagnosis of neonatal sepsis.
SUMMARY: The lack of an accepted consensus definition for neonatal sepsis impedes
our efforts toward improved diagnostic and prognostic options, and accurate
outcomes information for this vulnerable population.