The “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Specific Neonatal Case definitions (NEO).
NEO-CSEP: clinical sepsis in neonates.
All of the three following criteria:
and two of the following criteria (without other apparent cause):
A one-time detection of coagulase-negative staphylococci (CNS) in blood cultures should not exclude the diagnosis of clinical sepsis. A clinical sepsis can also be diagnosed with a single positive blood culture with CNS, which is considered as a blood culture contamination, while other criteria of CNS bloodstream infection are not met and criteria of clinical sepsis have been met.
NEO-LCBI: laboratory-confirmed BSI.
a recognised pathogen other than coagulase-negative staphylococci (CNS) cultured from blood or cerebrospinal fluid (CSF; this is included because meningitis in this age group is usually haematogenous, so positive CSF can be regarded as evidence of BSI even if blood cultures are negative or were not taken).
Further instructions for reporting:
NEO-CNSB: laboratory-confirmed BSI with coagulase-negative staphylococci.
CNS is cultured from blood or catheter tip;
new infiltrate, consolidation or pleural effusion on chest x-ray;
and at least four of:
temperature> 38 °C or < 36.5 °C or temperature instability, tachycardia or bradycardia, tachypnoea or apnoea, dyspnoea, increased respiratory secretions, new onset of purulent sputum, isolation of a pathogen from respiratory secretions, C-reactive protein > 2.0 mg/dL, I/T ratio > 0.2.
NEO-NEC: necrotising enterocolitis.
or at least one characteristic radiographic abnormality (pneumoperitoneum, pneumatosis intestinalis, unchanging ‘rigid’ loops of small bowel)
plus at least two of the following without other explanation:
vomiting, abdominal distention, prefeeding residuals, persistent microscopic or gross blood in stools.
Link to European IC/HH Core Competencies
Area 3. Surveillance and investigation of healthcare associated infection (HAI)