[INFECTIOUS DISEASE ASSESSMENT OF TERM INFANTS WITH RISK FACTORS - EVALUATION OF NECESSITY AND METHODS OF PREVENTION].

ABSTRACT

AIMS: To characterize the demography of infants for whom blood tests were indicated due to perinatal risk factors for infection and to elaborate on ways to minimize these invasive tests. METHODS: A retrospective study based on an analysis of the medical records of term and late-preterm infants born between January 1st, 2013 and December 31st, 2015, for whom blood cultures were indicated due to maternal risk factors. RESULTS: The study included 583 infants. Each infant had between 1 to 4 cultures taken (an average 1.9) - reaching a total of 1041 cultures, 11 of which were positive (1.05%). We discovered no statistically significant relationship between positive blood cultures and the duration of membrane rupture. Moreover, no significant relationship was detected between positive blood cultures and membrane rupture lasting more than 18 hours (despite shorter durations of antibiotic treatment - less than 4 hours). Among those with positive blood cultures, we found a statistically significant relationship between carriers of Group B streptococcus (GBS) born at 35-36 gestation and membrane ruptures lasting 14 hours or less. On the other hand, maternal fever was related to membrane rupture lasting 14-18 hours, but not to membrane rupture lasting 18 hours or more. When evaluating the rate of positive cultures in our study, no statistically significant difference was found between Arab and Jewish populations. CONCLUSIONS: Our findings support the presumption that the benefit of blood tests taken in healthy neonates with maternal risk factors is questionable; Out of 583 infants, only 11 had positive blood cultures. The policy of initiating antibiotic treatment 14 hours after membrane rupture has little or no value in preventing the need for assessing those born 18 hours or more after membrane rupture. This study joins other studies around the world that support the conclusion that there is a very small benefit in blood tests taken from a healthy newborn with maternal risk factors. Other ways of assessing the presence of congenital infection in a healthy newborn with maternal risk factors should be found.