Noa Fleiss, MD, MPH
Assistant Professor of PediatricsCards
About
Research
Publications
2025
Reducing tracheal intubation adverse events and severe desaturations by increasing intubation premedication use in infants <1500 g: a quality improvement initiative
Daniel J, Johnston L, DeMartino C, Blythe E, Beres S, Garcia C, Fleiss N. Reducing tracheal intubation adverse events and severe desaturations by increasing intubation premedication use in infants <1500 g: a quality improvement initiative. Journal Of Perinatology 2025, 1-7. PMID: 41286422, DOI: 10.1038/s41372-025-02517-5.Peer-Reviewed Original ResearchRapid sequence intubationAdverse eventsVLBW infantsSevere desaturationImmediate extubationNeonatal safetyPremedication practicesPremedication useProcedural safetyAnalgesic agentsSequence intubationInfantsIntubationParalytic agentsPremedicationBackgroundTracheal intubationQuality improvement initiativesMultidisciplinary teamDesaturationVLBWFactors associated with persistent bloodstream infection in the Neonatal Intensive Care Unit
Lee H, Fleiss N, Bizzarro M, Feinn R, Rychalsky M, Puthawala C, Peaper D, Murray T. Factors associated with persistent bloodstream infection in the Neonatal Intensive Care Unit. Journal Of Perinatology 2025, 1-7. PMID: 41203901, DOI: 10.1038/s41372-025-02460-5.Peer-Reviewed Original ResearchPersistent bloodstream infectionBloodstream infectionsBlood culturesNeonatal intensive care unitRecovery of Staphylococcus aureusEarly-onset sepsisLate-onset sepsisPositive blood culturesCentral venous catheterIntensive care unitIndex cultureNo infantVenous cathetersDiagnostic stewardshipCenter studyMale sexCare unitInfantsMicrobial characteristicsNICUSepsisResultsThe recoveryInfectionMicrobiological variablesNeonatesReducing MSSA Invasive Infection and Transmission in the NNICU using Whole Genome Sequencing and Environmental Surveillance.
Murray T, Wright J, Peaper D, Bizzarro M, Fleiss N, Krechevsky K, Rivera-Vinas J, Hitchings R, Durant T. Reducing MSSA Invasive Infection and Transmission in the NNICU using Whole Genome Sequencing and Environmental Surveillance. Antimicrobial Stewardship & Healthcare Epidemiology 2025, 5: s32-s33. PMCID: PMC12460720, DOI: 10.1017/ash.2025.232.Peer-Reviewed Original ResearchMSSA isolatesMSSA colonizationMethicillin resistanceInvasive infectionsWhole-genome sequencingInvasive MSSA infectionsInvasive Staphylococcus aureusIntensive care unitHospital-acquired infectionsInfection prevention interventionsBelow-the-elbowSheep blood agarMSSA infectionsMSSA strainsStaphaurex testGenome sequenceHand hygiene complianceMSSAMode of transmissionNICUCare unitPatientsColonization rateBlood agarColumbia sheep blood agarAfter an initial positive blood culture, when are repeat blood cultures necessary in the Neonatal Intensive Care Unit (NNICU)?
Murray T, Lee H, Peaper D, Bizzarro M, Fleiss N. After an initial positive blood culture, when are repeat blood cultures necessary in the Neonatal Intensive Care Unit (NNICU)? Antimicrobial Stewardship & Healthcare Epidemiology 2025, 5: s90-s90. PMCID: PMC12461539, DOI: 10.1017/ash.2025.317.Peer-Reviewed Original ResearchNeonatal intensive care unitCentral venous catheterPersistent bloodstream infectionRecovery of S. aureusPositive blood culturesBloodstream infectionsBlood culturesRisk factorsStreptococcal infectionHospital Neonatal Intensive Care UnitEarly onset sepsisEmpirical antibiotic therapyInitial blood cultureCongenital heart diseaseWhite blood cell countFactors associated with persistenceBlood cell countIntensive care unitPotential risk factorsOnset sepsisNo babiesAntibiotic therapyImmunosuppressive agentsPremature babiesVenous catheters
2024
The diagnostic utility of obtaining two blood cultures for the diagnosis of early onset sepsis in neonates
Fleiss N, Shabanova V, Murray T, Gallagher P, Bizzarro M. The diagnostic utility of obtaining two blood cultures for the diagnosis of early onset sepsis in neonates. Journal Of Perinatology 2024, 44: 745-747. PMID: 38409330, DOI: 10.1038/s41372-024-01914-6.Peer-Reviewed Original ResearchPremedication for Neonatal Intubation
DeMartino C, Fleiss N. Premedication for Neonatal Intubation. 2024, 195-220. DOI: 10.1007/978-3-031-71946-2_12.Peer-Reviewed Original ResearchNeonatal intubationIntubation-surfactant-extubationCanadian Paediatric SocietyAmerican Academy of PediatricsAcademy of PediatricsAirway anomaliesSurfactant administrationNeonatal populationIntubation attemptsPaediatric SocietyIntubationPremedicationAmerican AcademyReview circumstancesNeonatesVagolyticsPainAnalgesicAirwaySedationPediatric
2023
Improving Early Colostrum Administration to Very Low Birth Weight Infants in a Level 3 Neonatal Intensive Care Unit: A Quality Improvement Initiative
Fleiss N, Morrison C, Nascimento A, Stone D, Myers E. Improving Early Colostrum Administration to Very Low Birth Weight Infants in a Level 3 Neonatal Intensive Care Unit: A Quality Improvement Initiative. The Journal Of Pediatrics 2023, 260: 113421. PMID: 37076038, DOI: 10.1016/j.jpeds.2023.113421.Peer-Reviewed Original ResearchConceptsLevel 3 neonatal intensive care unitNeonatal intensive care unitIntensive care unitOral immune therapyQuality improvement initiativesCare unitVLBW infantsOutcome measuresHuman milkLow birth weight infantsMultidisciplinary quality improvement initiativeBirth weight infantsSecondary outcome measuresElectronic health record usePrimary outcome measureLow birthweight infantsImprovement initiativesHealthcare Improvement's ModelWeight infantsOIT protocolImmune therapyBirthweight infantsColostrum administrationSignificant improvementBaseline meanShort course antibiotic therapy: When is no difference the same?
Fleiss N, Gurka M, Burchfield D. Short course antibiotic therapy: When is no difference the same? Journal Of Perinatology 2023, 43: 683-684. PMID: 37029166, DOI: 10.1038/s41372-023-01671-y.Peer-Reviewed Original ResearchReducing MRSA Infection in a New NICU During the COVID-19 Pandemic.
Barrett R, Fleiss N, Hansen C, Campbell M, Rychalsky M, Murdzek C, Krechevsky K, Abbott M, Allegra T, Blazevich B, Dunphy L, Fox A, Gambardella T, Garcia L, Grimm N, Scoffone A, Bizzarro M, Murray T. Reducing MRSA Infection in a New NICU During the COVID-19 Pandemic. 2023, 151 PMID: 36625072, DOI: 10.1542/peds.2022-057033.Peer-Reviewed Original ResearchConceptsInvasive MRSA infectionsInfection prevention strategiesMethicillin-resistant Staphylococcus aureusMRSA infectionOutcome measuresPrevention strategiesCOVID-19 pandemicMultidisciplinary quality improvement initiativeLevel IV NICUSubsequent invasive infectionsMRSA colonization rateCoronavirus disease 2019 (COVID-19) pandemicHealthcare Improvement's ModelQuality improvement initiativesDisease 2019 pandemicEffectiveness of interventionsPersonal protective equipmentSupply chain shortagesHospitalized neonatesInvasive infectionsPatient daysSkin colonizationHand hygieneMost NICUsNICU
2022
Sequential organ failure assessment scores to predict outcomes: from adults to neonates
Fleiss N, Polin R. Sequential organ failure assessment scores to predict outcomes: from adults to neonates. Current Opinion In Pediatrics 2022, 35: 218-222. PMID: 36449658, DOI: 10.1097/mop.0000000000001207.Peer-Reviewed Original ResearchConceptsSepsis-attributable mortalityNeonatal sepsisSOFA scoreAttributable mortalityPediatric populationSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreLow birth weight infantsNeonatal disease statesBirth weight infantsRisk of mortalityPatient safety outcomesSepsis definitionsWeight infantsPreterm infantsOrgan dysfunctionPrognostic utilityRisk stratificationClinical progressionAdverse outcomesPatient cohortLaboratory criteriaSeverity scoreSafety outcomesSepsis
Clinical Care
Overview
Noa Fleiss, MD, specializes in neonatal-perinatal medicine, with special interests in small baby care, noninvasive respiratory care, and infection prevention in the neonatal intensive care unit (NICU).
“I appreciate the transformative journey of newborns from the in-utero environment to the external world. I have a passion for helping those vulnerable infants who struggle with this transition,” Dr. Fleiss says. “Working closely with parents to ensure their newborns receive the best possible care is deeply rewarding. I enjoy supporting the health of the infant but also providing comfort and support to the parents during a critical time.
Dr. Fleiss is an assistant professor of pediatrics at Yale School of Medicine, where she acts as the director of quality improvement for the neonatal-perinatal medicine division. She also co-directs the quality improvement curriculum for trainees and mentors those interested in quality improvement projects. Her clinical research centers on neonatal infectious diseases, with a particular emphasis on diagnosis, prevention, and management of neonatal sepsis.
“Participating in quality improvement research allows me to witness real-time improvements in neonatal outcomes directly attributed to the implementation of evidence-based best practices. This immediate feedback and tangible impact on patient health are incredibly fulfilling,” she says.
Dr. Fleiss received her medical degree from Tufts University School of Medicine. She completed her pediatric residency and neonatology fellowship at New York-Presbyterian/Columbia University.
Clinical Specialties
Neonatal - Perinatal Medicine
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