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Unnecessary Workup of Asymptomatic Neonates in the Era of Group B Streptococcus Prophylaxis

机译:B组预防链球菌时代无症状新生儿的不必要检查

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摘要

Asymptomatic term neonates born to mothers who are Group B Streptococcus (GBS) unknown or GBS positive but “inadequately” treated prior to delivery do not require invasive laboratory evaluation. We conducted a retrospective cohort study of mother/baby dyads born from January 1, 2005 until September 30, 2007 at the Medical College of Georgia. Their current protocol is to obtain a Complete Blood Count with Differential (CBC with D), Blood Culture (BC), and C-reactive protein (CRP) after birth. Mother/baby dyads (n = 242) that met inclusion criteria were reviewed. Of these 242 babies 25 (10%) were started on antibiotics after the initial lab values were known. None of the blood cultures were positive and the CRP's were normal. The 2002 GBS guidelines call for laboratory evaluation of “at-risk” neonates, but the workup of these babies is not only costly, it does not provide any advantage over old fashioned clinical observation for the evaluation and treatment of early onset GBS sepsis.
机译:由B组链球菌(GBS)未知或GBS阳性但分娩前“治疗不当”的母亲所生的无症状足月新生儿不需要进行侵入性实验室评估。我们对佐治亚医学院的2005年1月1日至2007年9月30日出生的母婴进行了回顾性队列研究。他们目前的方案是在出生后获得具有差异的全血细胞计数(CBC和D),血液培养(BC)和C反应蛋白(CRP)。符合纳入标准的母亲/婴儿二倍体(n = 242)进行了回顾。在这242名婴儿中,有25名(10%)在最初的实验室值已知后开始使用抗生素。血培养无阳性,CRP正常。 2002年的GBS指南要求对“高危”新生儿进行实验室评估,但是对这些婴儿进行的检查不仅成本高昂,而且在评估和治疗早期发作的GBS败血症方面不如老式的临床观察方法有任何优势。

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