Does KP sepsis calculator provide more reliable, accurate and efficient screening and treatment for early onset neonatal sepsis as compared to NICE guidelines? KCH experience

Title : Does KP sepsis calculator provide more reliable, accurate and efficient screening and treatment for early onset neonatal sepsis as compared to NICE guidelines? KCH experience

Abstract:

Background: Early onset sepsis is a leading cause of morbidity and mortality in neonates requiring early detection and treatment. However, often it can present with non-specific clinical signs and symptoms. It is therefore important to have an effective screening tool which can be used to assess the risk of infection at birth.

Aim: The aim for this quality improvement project was to compare the effectiveness of using King’s College Hospital (KCH) Trust guidelines (based on the NICE for neonatal sepsis 20241) against the Kaiser Permanente (KP)calculator2 across both units at KCH and Princess Royal University Hospital (PRUH).

Method: This study looked at 199 patients who were started on intravenous antibiotics based on Trust guidelines at KCH and PRUH between August 2024 to January 2025, excluding those who required admission to NICU. Data was collected from electronic records and KP sepsis calculator recommendations were generated. Culture negative sepsis (CNS) was defined as first or 24 hour CRP > 10mmol/l PLUS 2 or more risk factors/clinical indicators for sepsis.

Results:

1. At PRUH (100 babies): 58% overtreated (defined as well babies with negative CRP) using Trust guidelines, 22% potential missed CNS using KP, 14% not for screen based on either guideline and 6% screened using either guidelines. 3% had positive blood culture with high CRP.
2. At KCH (99 babies): 71.2% overtreated using Trust guidelines, 17.4% potential missed CNS sepsis using KP,
3. 1% not for screen using either guideline and 6.1% treated with either guideline. 2% was not suitable for analysis. 3% had positive BC with high CRP.

Conclusion: In the population of patients at KCH and PRUH, use of KP protocols would result in a large proportion of potential cases of missed CNS sepsis and this study does not currently recommend switching to KP guidelines currently.

Biography:

Mohammed Sayeemuddin is a Senior Clinical Fellow in the Neonatal Medicine at King’s College Hospital, London with over 10 years of experience in neonatal and Paediatric medicine. He holds MBBS, DNB, DCH, and MRCPCH, reflecting comprehensive postgraduate training in paediatrics and neonatology. His clinical and academic interests focus on neonatal medicine, particularly the prevention, early diagnosis and management of neonatal infections. He has led and contributed to multiple QIP aimed at enhancing patient safety, optimizing clinical outcomes and improving service delivery within neonatal services. He is committed to evidence-based practice, multiprofessional collaboration and continuous professional development in neonatal care internationally.