Background Preterm infants are at an increased risk of developing early-onset sepsis compared to term infants. The reasons for this are numerous, but mainly revolve around their inherently immature immune system and its inability to fight pathogenic microorganisms effectively. The main cause of early-onset neonatal sepsis is vertical exposure to infectious pathogens which colonise the vaginal canal of the mother.
Aim To assess the incidence of sepsis in infants delivered by elective LSCS for maternal PET.
Methods Retrospective chart study of VLBW infants admitted to the NICU in the Rotunda Maternity Hospital in Dublin, between the years 2008–2011 following delivery by LSCS for maternal PET with no septic risk factors.
Results All 79 infants were of < 34 weeks gestation and had had septic work-ups completed on admission to the NICU. All of the infants were treated prophylactically for early-onset sepsis with antibiotics for 48 hours. Investigation of the septic screens included FBC, CRP and blood culture results at both 48 hour and 5 days. On review of all 79 septic screens, none of the infants had positive blood cultures at either 48 hours or 5 days. Similarly, none of the infants displayed any haematological signs indicative of early-onset sepsis. Mild deviations were observed in some of the haematological results, but these can explained by the effects of PET on the infant.
Conclusion Despite the absence of any early-onset septic risk factors, all 79 infants were unnecessarily treated with a 48 hour course of prophylactic antibiotics.