P280 Retrospective study of neonatal infection, clinical and laboratory criteria of hospital admission (2015–2016)

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Abstract

Background and aims

Neonatal infections (NI) among newborn during the neonatal period, may be contracted by transplacental transfer in utero, in the birth canal during delivery (perinatal), or by other means after birth. It is a retrospective recording of early and late NI of neonates hospitalised in pre-NICU during 2015–2016.

Methods

Recording of the cases of NI according to the ICD-10 system and excel editing.

Results

118 cases of NI have been collected, 61 (2015), 57 (2016), 38 females (33, 3%) and 80 males (67, 7%), in total. The neonates were referred from the OBGyn Department of Achillopouleio General Hospital(61,8%), the delivery room of the same hospital(24,5%), OBGyn Department of private hospitals(5,9%), paediatric private practice(6,7%) and 1 baby was born on board. 47,5%(56) had normal-labour and 52, 5%(62) cesarian-section. The amniotic fluid was dirty in 16%(19) and clear in 84% (99). The day of admission in the hospital was on the 1st, 2nd, 3rd and >4th day of life( 57%(67), 21%(25), 4%(5), 7%(8) and 11%(13), respectively). Blood cultures were done on all the babies on admission (positive with S. Epidermidis(0,85%). Other body fluid cultures included: Urine culture (22,8%), culture of faeces(1,69%), and orbital fluid(1,69%) with negative results. 11% (13) had lumbar puncture (0,84% positive for S. saprophyticus). 32,2%(38) neonates with TORCH investigation( 0,84% was positive for HSV). The clinical features on admission were lethargy 8,47%(10), feeding problems 16,9%(20), vomiting 9,3%(11), grunting 14,4%(17), tremor 3,38%(4), jaundice 16,9%(20), respiratory distress 9,3%(11), pallor 22%(26), apnea 13,5%(16), bloody faeces 0,85%(1), bradycardia 2,5%(3), hypoglycemia 0,85%(1), acrocyanosis 3,38%(4) and skin problems 2,5%(3). Lab results showed elevated CRP (>10):42,3% (50) and elevated WBC (>20000):31,3%(37), respectively. The drug treatment provided was: Ampicilline-Amicacine for 3 days (11,4%), 5 days(43,2%) and the rest different duration and combination of drug treatment.

Conclusion

The Department of Paediatrics personnel treated successfully the cases of NI, despite the absence of a neonatologist. Only 3 cases per year needed reference to tertiary hospital for further management. The admission criteria followed NICE guidelines.

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