Identification of sepsis is a major issue due to limitations in diagnosis and severity of outcome. Different
combinations of tests are used to screen babies at risk for infection, none specific enough to avoid treatment of noninfected
newborns. 193 newborns with ≥ 35 weeks of gestational age admitted in the maternity were screened for
infection using a protocol scoring system involving haematological values and CRP ≥ 10mg/l. Blood-cultures were taken
after treatment decision, before antibiotics were started. No microbiological exam was included in the screening.
Treatment decisions were taken by the staff irrespectively of the ongoing observational study.
Newborns were classified by the authors in 4 groups: infected (culture verified), strongly suspected infection (SSI), no
sepsis but treated (NST), no sepsis-no treatment (NSNT). Treatment decision was revaluated by the authors according to
different cut-off levels of CRP.
40 newborns (20.7%) received antibiotics. 2 had positive blood-cultures. 13 were classified as SSI (all treated) and 178 as
not infected (25 treated). All infected babies were identified but the error of the positive predictive value reached 62.5%.
Revaluation of treatment decisions with CRP cut-off levels of 15, 20 and 25 mg/l showed respectively 60.5%, 51.6 and
48% of error of the positive predictive value, the first two cut-offs missing no infected newborns but the last one missing
A new scoring system including CRP at 20mg/l has been in use since then without readmissions for infection and an
estimated reduction of 24% antibiotic treatment.