Defining neonatal sepsis.
Defining neonatal sepsis.
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DOI：
10.1097/mop.0000000000000315
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发表时间：
2016-04
影响因子：
3.6
通讯作者：
Wynn JL
中科院分区：
文献类型：
--
作者：
Wynn JL
尽管新生儿重症监护室（NICU）的感染率由于持续的质量改进措施而略有下降，但新生儿败血症仍然是住院早产儿中常见的毁灭性问题。尽管多次尝试解决这一未满足的需求，但在过去三十年中，诊断检测选项的临床管理、结局和准确性方面的进展甚微。医学缺乏进步的一个重要原因是疾病的病例定义不同。无法就精确的定义达成一致，大大降低了流行病学家、临床医生和研究人员的发现一致的可能性，这反过来又严重阻碍了改善结果的进展。儿科对脓毒症的共识定义在足月儿中不准确，也不适用于早产儿。与NICU中遇到的其他破坏性疾病的定义的多阶段标准（例如，支气管肺发育不良），研究者用于证实新生儿败血症诊断的标准存在显著差异。新生儿败血症缺乏公认的共识定义，阻碍了我们努力改善诊断和预后的选择，以及准确的结果信息，为这个脆弱的人群。
Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last three decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress towards improving outcomes. Pediatric consensus definitions for sepsis are not accurate in term infants and are not appropriate for preterm infants. In contrast to the defined multi-stage criteria for other devastating diseases encountered in the NICU (e.g., bronchopulmonary dysplasia), there is significant variability in the criteria used by investigators to substantiate the diagnosis of neonatal sepsis. The lack of an accepted consensus definition for neonatal sepsis impedes our efforts towards improved diagnostic and prognostic options as well as accurate outcomes information for this vulnerable population.