Clinical Observation of Newborns with Infection Risk: A Safe Practice

Introduction: Early-onset neonatal sepsis refers to an infection which starts during the first 72 hours of birth, and can lead to significant morbidity and mortality. Scientific evidence shows that infected infants present with symptoms during the first hours after delivery. There has been a significant decrease in this condition with the implementation of guidelines for its prevention. However, International guidelines still recommend the evaluation of these infants using painful tests. Material and methods: A prospective cohort study was conducted on all asymptomatic infants born at >35 weeks gestation with one or more risk factors in a single tertiary care centre from 2011 to 2015. They were periodically observed in newborn nursery from admission until discharge looking for signs of infection. Results: Out of the 9,424 babies born during this period, 1425 were included in the study. A total of 53 infants were admitted to the neonatal unit, half of them because of sepsis suspicion. Finally, just 7 were discharged with the diagnosis of sepsis. All these 7 presented with symptoms during their first 72 hours of life. No sepsis was reported in asymptomatic infants. Conclusions: Truly infected infants present with symptoms during their first hours of life. This study supports the observation of infants at risk as a safe practice to detect early-onset sepsis. (C) 2017 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. All rights reserved.