PO-0574 Indications And Outcomes Of Lumbar Punctures In Term Neonates In A Tertiary Neonatal Unit

Abstract

Background Lumbar puncture (LP) is usually performed when there is a clinical suspicion of meningitis in babies with suspected sepsis. NICE recently published their guidelines on 'antibiotics for early-onset neonatal infections' with guidance on when LPs should be considered. Aim To audit the indications and outcomes of LPs performed in term babies (>37 + 0 weeks) in a tertiary neonatal unit. Methods A list of term babies who had an LP was obtained from the Microbiology Department between 01/01/2010 and 31/12/2013. The Badger electronic patient record and hospital blood results systems were reviewed to collect the data. Results In the last 4 years we had 2,882 term babies admitted to the neonatal unit. 136 LPs were performed in 133 term babies. The reasons for LPs were; (a) raised CRP in 106 cases (median CRP was 70), (b) abnormal neurology in 18 cases, (c) positive blood culture in 8 cases and (d) 4 were for no other clinical focus. There was one culture of coliforms and another positive for herpes simplex virus type 1 on PCR. At discharge, 8 had a diagnosis of meningitis and 1 with encephalitis. Conclusion The predominant indication for LPs in term babies was a raised CRP. We only isolated organisms from two samples. As per NICE guidance, we rely on a combination of clinical findings and CRPs when deciding which term babies to LP.