Table 2.
Selected examples of suggested neonatal sepsis definition from experts or societies.
| Authors or society | Criteria | Comment |
|---|---|---|
| International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics−2005 (38) |
Systemic inflammatory response syndrome (SIRS) criteria−1st week of life • Heart rate < 180/min or < 100/min • Respiratory rate > 50/min • WBC > 34 × 109/mL • Core temperature of > 38.5°C or < 36°C Sepsis; SIRS in the presence of suspected or proven infection |
Evidence of infection vaguely described |
| European Medicines Agency definition from 2010 (39) |
Criteria for inclusion in a neonatal sepsis clinical trial Clinical sign (temperature instability, cardiovascular instability, skin symptoms, respiratory instability, gastrointestinal symptoms, non-specific symptoms) Laboratory signs: Low/high WBCs, I/T-ratio > 0.2, Platelet count < 100, CRP > 15 mg/L or PCT > 2 ng/mL, glucose intolerance and metabolic acidosis |
Laboratory signs unspecific and cut-offs with poor predictive ability and not age adapted (PCT) |
| Wynn and Polin −2018 (2) |
Hypothetical neonatal sequential organ failure assessment (nSOFA) score Including the following 6 items with scores from 0 to 3: Respiratory status, cardiovascular status, platelet counts, absolute neutrophil count, renal function, and CNS function |
Inclusion of WBC indices with poor predictive values. |
| Hakonsson−2017 (40) |
Definition of a clinical, culture-negative GBS sepsis (in retrospect) • Relevant symptoms and/or a CRP ≥ 25 mg/L • GBS in the maternal vaginal/rectal swabs or superficial infant cultures • The initiation of antibiotic therapy in the infant |
Clinical signs not specified |
| Norwegian Neonatal Society (10) |
Definition of a culture-negative sepsis (in retrospect) • Clinical symptoms • CRP > 30 mg/L • Other known clinical reasons for increased CRP excluded • Received antibiotics ≥ 5 days |
Clinical signs not specified. Duration of antibiotics as a criteria not useful prospectively |
CRP, C-reactive protein; GBS, group B streptococci; CNS, central nervous system; WBC, white blood cells; PCT, procalcitonin, I/T ratio-immature to total neutrophil ratio.