Pediatrics
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Multicenter Study
Evaluation and treatment of neonates with suspected late-onset sepsis: a survey of neonatologists' practices.
To ascertain current diagnostic and treatment practices for suspected late-onset sepsis in infants in neonatal intensive care units (NICUs) and identify areas that may benefit from clinical practice guidelines. ⋯ Neonatologists varied in management of suspected late-onset sepsis, particularly that caused by CoNS. Procedures to prevent CoNS-positive blood cultures and to differentiate CoNS contaminants from pathogens are needed. For safely decreasing vancomycin use in NICUs, clinical practice guidelines should be developed, implemented, and evaluated. The guidelines should include optimal skin antisepsis and catheter disinfection before obtaining blood for culture, obtaining 2 blood cultures and using adjunctive tests and information to help differentiate contaminants from pathogens, and restriction on empiric vancomycin use.