Group B streptococcus; Belgium; Guideline; Management; Neonate
Abstract :
[en] Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial
prophylaxis, early onset sepsis in neonates remains a common source of neonatal morbidity and mortality especially in preterm neonates. The identification of neonates with early onset sepsis is usually based on perinatal risk factors. Clinical signs are aspecific and laboratory tests not sensitive.
Therefore, many clinicians will overtreat at risk infants. Inappropriate treatment with antibiotics
increases the risk for late onset sepsis, necrotizing enterocolitis, mortality and prolongs hospitalisation and costs. In 2003, the Belgian Health Council (BHC), published guidelines for the prevention of perinatal GBS infections. This report presents the Belgian paediatric management guidelines, which have been endorsed by the Belgian and Flemish societies of neonatology and paediatrics. The most imported changes in the 2014 guidelines are the following:
· recommendations for a lumbar puncture,
· clarification of normal spinal fluid parameters and blood neutrophil indices corrected for gestation age,
· specific timing for diagnostic testing after birth,
· no indication for diagnostic testing in asymptomatic newborns unless additional risk factors,
· a revised algorithm for management of neonates according to maternal and neonatal risk factors,
· premature infants described as those below 35 weeks instead of 37 weeks
The guidelines were made on the basis of the best evidence and on expert opinion when inadequate evidence exists.
Disciplines :
Public health, health care sciences & services Pediatrics Laboratory medicine & medical technology Reproductive medicine (gynecology, andrology, obstetrics) Immunology & infectious disease
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