Background Lumbar puncture (LP) is usually performed when there is a clinical suspicion of meningitis in babies with suspected sepsis. NICE recently published their guidelines on ‘antibiotics for early-onset neonatal infections’ with guidance on when LPs should be considered.
Aim To audit the indications and outcomes of LPs performed in term babies (>37 + 0 weeks) in a tertiary neonatal unit.
Methods A list of term babies who had an LP was obtained from the Microbiology Department between 01/01/2010 and 31/12/2013. The Badger electronic patient record and hospital blood results systems were reviewed to collect the data.
Results In the last 4 years we had 2,882 term babies admitted to the neonatal unit. 136 LPs were performed in 133 term babies. The reasons for LPs were; (a) raised CRP in 106 cases (median CRP was 70), (b) abnormal neurology in 18 cases, (c) positive blood culture in 8 cases and (d) 4 were for no other clinical focus. There was one culture of coliforms and another positive for herpes simplex virus type 1 on PCR. At discharge, 8 had a diagnosis of meningitis and 1 with encephalitis.
Conclusion The predominant indication for LPs in term babies was a raised CRP. We only isolated organisms from two samples. As per NICE guidance, we rely on a combination of clinical findings and CRPs when deciding which term babies to LP.
References Antibiotics for early-onset neonatal infection – NICE www.nice.org.uk/nicemedia/live/13867/60633/60633.pdf?