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Multicenter Study
. 2018 Mar;35(4):385-389.
doi: 10.1055/s-0037-1607420. Epub 2017 Oct 30.

Evaluation of Early Onset Sepsis, Complete Blood Count, and Antibiotic Use in Gastroschisis

Sadie L Williams  1 , Matthew Leonard  1 , Eric S Hall  1 , Jose Perez  2 , Jacqueline Wessel  2 , Paul S Kingma  1   3
Affiliations
Multicenter Study

Evaluation of Early Onset Sepsis, Complete Blood Count, and Antibiotic Use in Gastroschisis

Sadie L Williams et al. Am J Perinatol. 2018 Mar.

Abstract

Objective: Gastroschisis is a congenital defect in which the abdominal viscera herniate through the abdominal wall. In this population, antibiotics are often initiated immediately following delivery; however, this may be unnecessary as infections typically develop as a consequence of chronic issues in gastroschisis. The objective of this study was to evaluate the incidence of culture positive early onset sepsis, the reliability of the immature to mature neutrophil count (I:T) ratio as an infectious biomarker, and antibiotic use in infants with gastroschisis.

Study design: This retrospective chart review analyzed clinical data from 103 infants with gastroschisis and 103 weight-matched controls that were evaluated for early onset infection.

Results: Compared with the control group, there was a significantly increased percentage of infants with an I:T ratio > 0.2 in the gastroschisis group (43% vs. 12%, p < 0.001) and an increased percentage of infants exposed to greater than 5 days of antibiotics regardless of their I:T ratio (75% vs. 6%, p < 0.001). There were no episodes of culture positive early onset sepsis in either group.

Conclusion: Our results indicate that I:T ratio is not a reliable marker of infection in gastroschisis, and suggest that empiric septic evaluation and antibiotic use, immediately following delivery in gastroschisis infants, may be unnecessary.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Selection process of gastroschisis and weight-matched non-gastroschisis control groups.
Figure 2
Figure 2
Comparison of I:T ratio elevation in infants with gastroschisis compared to those with intact abdominal walls. * indicates statistically significant difference between the groups.
See this image and copyright information in PMC

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