Can we improve early identification of neonatal late-onset sepsis? A validated prediction model

Ori Goldberg, Nofar Amitai, Gabriel Chodick, Reuben Bromiker, Oded Scheuerman, Haim Ben-Zvi, Gil Klinger

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: No single test can accurately identify neonatal late-onset sepsis (LOS). Our aim was to use clinical evaluation with laboratory tests to rapidly assess sepsis risk. Study design: A retrospective case-control study was performed in a tertiary Neonatal Center during the years 2016–2019. Infants with bacteriologically confirmed LOS were compared with control infants. A clinical health evaluation score was assigned to each infant. A prediction model was developed and validated by multivariable analysis. Results: The study included 145 infants, 48 with sepsis, and 97 controls. LOS was independently associated with: sick appearance (OR: 5.7, 95% CI: 1.1–29.1), C-reactive protein > 0.75 (OR: 5.4, 95% CI: 1.1–26.3), and neutrophil-to-lymphocyte ratio > 1.5 (OR: 6.7, 95% CI: 1.2–38.5). Our model had an area under the receiver operating characteristic curve of 0.92 (95% CI: 0.86–0.97). Conclusions: Clinical evaluation with neutrophil-to-lymphocyte ratio and C-reactive protein can rapidly identify LOS enabling decreased health costs and antibiotic use.

Original languageEnglish
Pages (from-to)1315-1322
Number of pages8
JournalJournal of Perinatology
Issue number9
StatePublished - 1 Sep 2020
Externally publishedYes

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Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.


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