Article Text

DEFINITIONS OF SIRS AND SEPSIS IN CORRELATION WITH EARLY ONSET BACTERIAL INFECTION (EOBI) OF THE NEWBORN
  1. N Hofer1,
  2. W Mueller1,
  3. B Resch1
  1. 1Paediatric Department, Medical University Graz, Graz, Austria

Abstract

Background In 2002 the International Pediatric Sepsis Consensus Conference defined SIRS (systemic inflammatory response syndrome) and sepsis for paediatric patients. The aim of this study was to examine their practical usability and applicability for term and preterm newborns in the diagnosis of EOBI.

Methods In a retrospective analysis 662 newborns hospitalized during the last four years (2004–2007) at the NICU, Department of Pediatrics, Medical University of Graz, were scheduled in EOBI positive and negative groups by the following definitions: clinical signs of sepsis with positive culture or presence of maternal risk factors or positive laboratory tests. Findings were compared to the definitions of SIRS and sepsis.

Results 122 of 662 infants had diagnosis of EOBI, 11 of them were culture positive. The definitions of SIRS and sepsis applied to 214 and 168 newborns, respectively. SIRS criteria were fulfilled in 5/11 newborns (45%) with culture positive EOS and in 70/111 newborns (63%) with culture negative EOS. The correlation of sepsis definition and EOBI was almost identical. The incidence of EOBI was 18% and 19% in term and preterm infants, respectively. SIRS and sepsis were diagnosed more frequently in preterm (38% and 30%, respectively) compared to term infants (20% and 15%, respectively).

Conclusion The actual definition of SIRS was not helpful in the diagnosis of EOBI of the newborn. Especially in the preterm infant SIRS and sepsis definitions are frequently not consistent with EOBI.

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