Is your trust involved in the medical care of infants in the first 72 hours of life? Yes.
If no, please answer only the above question and respond to this request
If yes, I would be grateful if you could also answer the following:
- Do you have a guideline for the investigation and treatment of early onset infection/sepsis in neonates (names will vary)? Yes
- Does your guideline use NICE or Kaiser Permanente criteria for assessment of infants at risk of early onset neonatal sepsis? NICE
- Within your early onset neonatal sepsis guideline what are the indications for lumbar puncture? Indications for Lumbar Puncture:
1. CRP > 20 + ANY ONE OF THE FOLLOWING: (The rational for CRP>20 is that babies with a CRP above that value are treated with a full course of antibiotics for presumed sepsis at LWNC)
a. Maternal GBS sepsis (positive blood or CSF culture in Mum’s cultures)
b. Significant maternal sepsis (NOT ‘SEPTIC BUNDLE’) – Details below
c. Lack of clinical / CRP response to antibiotics
2. In the following group of babies an LP is indicated irrespective of CRP
a. Blood culture positive (Early onset neonatal sepsis)
b. Persistent Clinical signs of sepsis (as discussed with registrar/consultant).
Indications for Lumbar Puncture in NICU babies:
1. Any blood culture positive babies (except CONS)
2. If being treated for LONS (Late onset neonatal sepsis) as indicated by CRP >20 unless specific focus is identified such as C:ASI or NEC
3. Witness seizures
4. Clinical encephalopathy
4. How many lumbar punctures has your trust carried out in infants under 72 hours of age in the last 12 months? 54
5. How many of these had positive CSF cultures (not including bacterial PCR)? The Trust do not collect this data.
6. How many infants under 72 hours of age were diagnosed with meningitis in the last 12 months in your trust? < 5
7. How many infants between 72 hours of age and 7 days of age were diagnosed with meningitis in your trust? < 5
