Identification of newborns at risk of early-onset neonatal infection: New French guidelines and practices at Nantes University Hospital.

New French guidelines in 2017 aimed to improve the identification of newborns at risk of early-onset neonatal infection (EONI). Identification is based on perinatal risk factors, management of perinatal antibiotic prophylaxis, and standardized clinical assessment. We conducted a retrospective cross-study at the University Hospital of Nantes. The main objective was to assess implementation of the French guidelines. Of 1240 births included, 40% (501) required perinatal antibiotic prophylaxis (adequate in 67.3%) and 306 (24.7%) needed a standardized clinical assessment (performed in 69.2%). Only two newborns (0.16%) included in the study received neonatal antibiotic therapy. On the basis of the assessment conducted in our maternity ward, implementation of the recommendations seems to be effective.

Should central venous catheters be rapidly removed to treat Staphylococcus aureus related-catheter bloodstream infection (CR-BSI) in neonates and children? An 8-year period (2010-2017) retrospective analysis in a French University Hospital.

Catheter-related bloodstream infection (CR-BSI) treatment is based on empiric antibiotherapy associated with or without catheter removal. The aim of this study was to compare the incidence of failures in neonates and children with Staphylococcus aureus CR-BSI with or without rapid catheter removal. Treatment failure was defined as the persistence of positive blood cultures, onset or aggravation of a local or systemic complication, or relapse. Fifty-four CR-BSI in 225 patients were analysed (33 and 21 conservative and non-conservative treatments) with three and 10 failures, respectively (P<0.002). Non-conservative treatment with rapid catheter removal seems to be associated with a significantly lower failure rate and should be recommended.