Skip to main content
PAS 2024 Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Pre-Conference Ticketed Event
Pre-Conference Ticketed Event
APA Award Winner
APA Award Winner
APS Award Winner
APS Award Winner
ASPN Award Winner
ASPN Award Winner
SPR Award Winner
SPR Award Winner
On Demand Presentation
On Demand Presentation
Poster Icons
SPR Award Winner
SPR Award Winner
Back

Neonatology

Session: Neonatal Infectious Diseases/Immunology 2

605 - Do well appearing hypothermic infants need an early-onset sepsis evaluation?

Friday, May 3, 2024
5:15 PM – 7:15 PM ET
Poster Number: 605
Publication Number: 605.483

    Presenting Author(s)

  • Amy J. Sloane, MD, MHS (she/her/hers)

    Neonatologist, Assistant Professor of Pediatrics
    Nemours/Sidney Kimmel Medical College at Thomas Jefferson University
    Dresher, Pennsylvania, United States



Background: Diagnosing early-onset sepsis (EOS) in neonates within the first 72h of life can be challenging due to the nonspecific signs and symptoms. Hypothermia is a key factor in suspecting EOS, but it is common in both term and late preterm infants, and so it is unclear if the presence of hypothermia in an otherwise well-appearing infant should prompt a full evaluation for EOS. In most institutions, including our own, a sepsis evaluation requires admission to the neonatal intensive care unit (NICU), resulting in maternal-infant separation and increased resource use.

Objective: To evaluate the diagnostic value of hypothermia for EOS in infants admitted to the NICU for EOS evaluation.

Design/Methods: This is a retrospective study of neonates born ≥35 weeks’ gestation at a tertiary care center between April 2017 and August 2022. We included infants who were found to be hypothermic to ≤36.5°C via either axillary or rectal temperature measurements and who were admitted to our Level 3 NICU. We determined the number of infants who underwent EOS evaluation and evaluated the outcomes of their laboratory workup.

Results: A total of 105 infants were admitted to our NICU for hypothermia (defined as persistent axillary temperature of < 36.4C) and were included in our study. Of these infants, 22.9% were SGA ( < 10th percentile for weight), 32.3% were late preterm (35 0/7 - 36 6/7 weeks gestation), and 5.7% of infants were born to mothers with a diagnosis of chorioamnionitis. Isolated hypothermia with no additional symptoms occurred in 59% of the infants. A blood culture was sent in 43% of infants, 58.1% of infants had at least one CBC sent, and 17.1% of infants were treated with empiric antibiotics. There were no cases of culture-positive EOS.

Conclusion(s): The prevalence of EOS in hypothermic infants is low. NICU admission and laboratory workup and empiric antibiotics is probably unnecessary in hypothermic infants who are otherwise well appearing without additional symptoms.