neonatal_eos_calculator: Neonatal Early-Onset Sepsis (EOS) Calculator

In cliot: Clinical Indices and Outcomes Tools

Neonatal Early-Onset Sepsis (EOS) Calculator

Description

Calculates the probability of Early-Onset Sepsis (EOS) in newborns (>= 34 weeks gestation) based on maternal risk factors and the infant's clinical presentation. It uses a multivariate risk model (based on the Kaiser Permanente study) to adjust the prior probability derived from maternal factors by the likelihood ratio of the neonatal clinical status.

Usage

neonatal_eos_calculator(gestational_age_weeks, highest_maternal_temp_c,
                        rom_hours, gbs_status, intrapartum_antibiotics,
                        neonatal_appearance, baseline_incidence_per_1000 = 0.5)

Arguments

gestational_age_weeks	Numeric. Gestational age in weeks (must be >= 34).
highest_maternal_temp_c	Numeric. Highest maternal antepartum temperature in degrees Celsius.
rom_hours	Numeric. Duration of Rupture of Membranes in hours.
gbs_status	String. Maternal Group B Streptococcus status. Options: "positive", "negative", "unknown".
intrapartum_antibiotics	String. Type and duration of intrapartum antibiotics. Options: "none" (None or <2h before delivery), "specific_lt_2" (GBS Specific < 2h), "specific_2_to_3_9" (GBS Specific 2-3.9h), "specific_ge_4" (GBS Specific >= 4h), "broad_lt_2" (Broad Spectrum < 2h), "broad_2_to_3_9" (Broad Spectrum 2-3.9h), "broad_ge_4" (Broad Spectrum >= 4h).
neonatal_appearance	String. Clinical presentation of the neonate. "well_appearing": Normal exam. "equivocal": Abnormal vitals (e.g., tachycardia, tachypnea) but clinically stable. "clinical_illness": Severe respiratory distress, shock, need for mechanical ventilation/pressors.
baseline_incidence_per_1000	Numeric. The local baseline incidence of EOS per 1000 live births (default 0.5).

Value

A list containing:

EOS_Risk_Per_1000	The calculated posterior probability of sepsis per 1000 births.
Clinical_Presentation	The input clinical status used for the likelihood ratio adjustment.
Recommendation	Management guidance based on the calculated risk and clinical status (Routine care, Enhanced observation, or Antibiotics).

References

Puopolo KM, Draper D, Wi S, et al. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics. 2011;128(5):e1155-1163. Puopolo KM, et al. Management of Neonates Born at >=34 6/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. 2018.

Examples

# Example 1: Well appearing, 40 weeks, GBS neg, PROM 18h, Temp 38.5C
neonatal_eos_calculator(40, 38.5, 18, "negative", "none", "well_appearing")

# Example 2: Equivocal exam, 36 weeks, GBS pos, No Abx
neonatal_eos_calculator(36, 37.0, 12, "positive", "none", "equivocal")

cliot documentation built on Dec. 1, 2025, 1:06 a.m.