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. Pediatrics 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 outcomesSepsisWhat’s new in the management of neonatal early-onset sepsis?
Fleiss N, Schwabenbauer K, Randis TM, Polin RA. What’s new in the management of neonatal early-onset sepsis? Archives Of Disease In Childhood - Fetal And Neonatal Edition 2022, 108: 10-14. PMID: 35618407, DOI: 10.1136/archdischild-2021-323532.Peer-Reviewed Original ResearchInfection prevention for extremely low birth weight infants in the NICU
Fleiss N, Tarun S, Polin RA. Infection prevention for extremely low birth weight infants in the NICU. Seminars In Fetal And Neonatal Medicine 2022, 27: 101345. PMID: 35550785, PMCID: PMC9006400, DOI: 10.1016/j.siny.2022.101345.Peer-Reviewed Original ResearchConceptsInfection preventionLow birth weight infantsEarly antibiotic exposureBirth weight infantsHuman milk feedingPreterm newborn infantsSARS-CoV-2 global pandemicUse of probioticsAntifungal prophylaxisEnteral feedingWeight infantsPreterm infantsProlonged hospitalizationEvidence-based practiceMilk feedingNewborn infantsAntibiotic exposureInvasive interventionsSystemic infectionImmune defenseInfantsInfectionPreventionSuch interventionsNICU
2021
Can we back off using antibiotics in the NICU?
Fleiss N, Hooven TA, Polin RA. Can we back off using antibiotics in the NICU? Seminars In Fetal And Neonatal Medicine 2021, 26: 101217. PMID: 33678550, DOI: 10.1016/j.siny.2021.101217.Peer-Reviewed Original ResearchConceptsMulti-drug resistant organismsLong-term adverse effectsCulture-positive sepsisAntibiotic prescribing practicesDelaying antibioticsNeonatal sepsisPositive sepsisPrescribing practicesAntibiotic utilizationNeonatal ICUAntibiotic stewardshipAntibiotic useAntibiotic overuseResistant organismsAdverse effectsAntibioticsSepsisNICUInfantsLaboratory testingICUNeonatesSpecified intervalsNeonatologistsEvaluation of the Neonatal Sequential Organ Failure Assessment and Mortality Risk in Preterm Infants With Late-Onset Infection
Fleiss N, Coggins SA, Lewis AN, Zeigler A, Cooksey KE, Walker LA, Husain AN, de Jong BS, Wallman-Stokes A, Alrifai MW, Visser DH, Good M, Sullivan B, Polin RA, Martin CR, Wynn JL. Evaluation of the Neonatal Sequential Organ Failure Assessment and Mortality Risk in Preterm Infants With Late-Onset Infection. JAMA Network Open 2021, 4: e2036518. PMID: 33538825, PMCID: PMC7862993, DOI: 10.1001/jamanetworkopen.2020.36518.Peer-Reviewed Original ResearchMeSH KeywordsBacteremiaCatheter-Related InfectionsFemaleFungemiaGestational AgeGram-Negative Bacterial InfectionsGram-Positive Bacterial InfectionsHospital MortalityHumansInfant, Extremely Low Birth WeightInfant, Extremely PrematureInfant, NewbornInfant, PrematureInfant, Very Low Birth WeightIntensive Care Units, NeonatalIntestinal PerforationMaleNeonatal SepsisOrgan Dysfunction ScoresPeritonitisPrognosisRisk AssessmentConceptsSequential Organ Failure AssessmentInfection-related mortalityLate-onset infectionOrgan Failure AssessmentPreterm infantsMortality riskConsensus definitionAcademic neonatal intensive care unitMulticenter retrospective cohort studyNeonatal intensive care unitMedian birth weightRetrospective cohort studyMedian gestational ageIntensive care unitCharacteristic curveFailure AssessmentTime of evaluationWeight infantsCohort studyOnset infectionPrimary outcomeTotal cohortCare unitGestational ageBirth weightClinical and vital sign changes associated with late-onset sepsis in very low birth weight infants at 3 NICUs.
Sullivan BA, Nagraj VP, Berry KL, Fleiss N, Rambhia A, Kumar R, Wallman-Stokes A, Vesoulis ZA, Sahni R, Ratcliffe S, Lake DE, Moorman JR, Fairchild KD. Clinical and vital sign changes associated with late-onset sepsis in very low birth weight infants at 3 NICUs. Journal Of Neonatal-Perinatal Medicine 2021, 14: 553-561. PMID: 33523025, PMCID: PMC8316489, DOI: 10.3233/npm-200578.Peer-Reviewed Original ResearchConceptsLate-onset sepsisLow birth weight infantsBirth weight infantsClinical signsWeight infantsHeart rateBaseline risk factorsVital sign changesNon-infectious conditionsAbnormal CBCFirst sepsisAbdominal distensionVLBW infantsCentral cathetersMechanical ventilationPremature infantsPostnatal ageBaseline variablesClinician documentationRisk factorsClinical changesSepsisInfantsVital signsLogistic regression