Stefanie Riddle, Isabella Zaniletti, Karna Murthy, Alaina Pyle, Ellen Bendel-Stenzel, Elizabeth Jacobson, Theresa Grover, Heidi Karpen, Franscesca Miquel-Verges, Sadie Williams, Jennifer Rumpel, Michael A Padula, CHNC Gastroschisis Focus Group
Treating intrapartum fever with antibiotics is a cost-effective strategy to reduce the adverse outcomes of untreated intrapartum fever. Adopting a protocol to treat all intrapartum fevers ≥38°C as chorioamnionitis with appropriate antibiotics may lead to improved outcomes and reduced costs.
OBJECTIVE: Identify clinical predictors of bloodstream (BSI) and urinary tract infections (UTI) in infants with gastroschisis.
STUDY DESIGN: Retrospective analysis of infants with gastroschisis admitted to 47 neonatal intensive care units (NICUs) contributing to the Children's Hospitals Neonatal Database (CHND) from 2010-23. Outcomes were occurrence of BSI or UTI before discharge. Generalized linear models with generalized estimating equation (GEE) to account for hospitals as clusters utilized to identify factors independently related to the outcomes.
RESULT: Of 3987 eligible infants, rates of early BSI (within 3 days of birth) were 0.4%, any BSI 7.6% and UTI 3.5%. Median age of infection was 32 days for BSI and 39 days for UTI. Bowel atresia, silo/staged closure, patch closure, and additional anomalies were independently associated with these infections.
CONCLUSION: We identified clinical predictors of BSI and UTI, which should facilitate limitation of antibiotic use in low risk patients.