ÁP DỤNG CÔNG CỤ DỰ ĐOÁN NEOS CỦA KAISER TRONG XỬ TRÍ TRẺ SƠ SINH NGHI NHIỄM KHUẨN HUYẾT SỚM Ở CÁC NƯỚC CÓ THU NHẬP TRUNG BÌNH – THẤP

Abstract

Background: The Kaiser NEOS calculator is effective in reducing unnecessary antibiotics in healthy infants. Available data on the effectiveness and safety of the Kaiser calculator are around 0.1-4/1,000 live births. There is no data on the application of the Kaiser calculator with an incidence rate > 4/1,000 live births.Objective: To compare the results of treatment recommendations for newborns ≥ 34 weeks of gestation with suspected sepsis with an incidence rate of 16/1.000 and 0.5/1,000 live births.Methods: Prospective, from November 1, 2021 to April 30, 2022 at the Nguyen Dinh Chieu Hospital.  Newborns ≥ 34 weeks gestation were born to mothers at risk or newborns with clinical symptoms within 12 hours of birth. Recorded features of mothers, clinicals of newborns, and recommended treatment of the Kaiser calculator at incidence rates of 16/1,000 and 0.5/1,000 live births.Results: 99 infants met the study criteria, and 14/99 (14.1%) infants were diagnosed with a probability of neonatal early-onset sepsis. Antibiotic recommendations were 42.4% (16/1.000 live births) and 37.4% (0.5/1.000 live births), respectively. At an incidence rate of 16/1,000 live births, the Kaiser calculator recommends blood cultures higher than 0.5/1,000 live births with 38.4% and 2%, respectively. Two infants with a probability of neonatal early-onset sepsis were missed at an incidence rate of 0.5/1.000 live births. Conclusion: Using the Kaiser calculator with a high incidence rate did not increase antibiotic recommendations. The Kaiser calculator missed newborns who needed antibiotics by using a lower incidence rate than it actually was. It is essential to use actual local incidence rates for accurate assessments.