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Master Thesis

Évaluation du nouvel algorithme de prise en charge des infections materno-foetales du CHU de Grenoble chez les nouveau-nés de terme ≥34SA : nouvel algorithme intégrant le dosage de la procalcitonine au sang du cordon

Abstract : Introduction: Diagnosis of early neonatal infection remains one of the greatest challenges in neonatology due to its difficulty to diagnose, its emergency and its potential fatality. Recent studies have shown that a diagnostic algorithm based on the dosage of Procalcitonin (PCT) in the blood cord, presented good diagnostic value. The CHU of Grenoble integrated this dosage into its new protocol. The main objective of our study was to prove that this new protocol allowed to decrease the rate of neonatal antibiotic treatment without missing real bacterial infections. Patients and method: All new-borns suspicious of a neonatal infection, born at the CHU in Grenoble, with a gestational age ≥ 34 weeks have been administered an antibiotic therapy from December 1st 2013 to December 31st 2014 (old algorithm) and from February 1st 2015 to January 31st 2016 (new algorithm). The main criteria for the principal judgment was the rate of new-borns administered an antibiotic therapy. Results: 56 new-borns have been included in the first period of the study and 62 in the second period. The new algorithm presents a significant reduction in the rate of asymptomatic children administered by antibiotic therapy (p<0,05), however, the period when this antibiotic therapy was administered, was shorter, with an average time of 3.6 days versus 5.2 days. The analysis of the PCT in the cord was 2.5 times less expensive than that of the gastric. Conclusion: The new algorithm offers a significant reduce of the number of asymptomatic new-borns treated as well as the duration of the antibiotic therapy and a less expensive alternative of exams.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01609487
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Jennifer Ledemazel. Évaluation du nouvel algorithme de prise en charge des infections materno-foetales du CHU de Grenoble chez les nouveau-nés de terme ≥34SA : nouvel algorithme intégrant le dosage de la procalcitonine au sang du cordon. Médecine humaine et pathologie. 2017. ⟨dumas-01609487⟩

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