Diagnostic Accuracy of Biomarkers for Early-Onset Neonatal Bacterial Infections: Evaluation of Serum Procalcitonin Reference Curves

Go, Hidetoshi; Nagano, Nobuhiko; Katayama, Daichi; Akimoto, Takuya; Takayuki, Imaizumi; Aoki, Ryoji; Hijikata, Makoto; Sato, Ayako; Kato, Ryuichi; Okahashi, Aya; Morioka, Ichiro

doi:10.3390/diagnostics10100839

Cited by 8 publications

(10 citation statements)

References 30 publications

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“…Previously, the clinical diagnosis of neonatal infectious diseases was based on the detection of peripheral blood WBC counts, and the results of WBC detection were affected by various factors, and some neonates had poor WBC count bases, and the detected WBC levels were still in the normal range even though bacterial infections had occurred in the body, so WBC could only be used as a routine reference index for the diagnosis of infectious diseases ( 21 , 22 ). CRP, synthesized by inflammatory factors stimulating hepatocytes, is an acute phase response protein that triggers immunomodulation, phagocytosis, formation of immune complexes, and activation of the complement system, and has been clinically used as a nonspecific marker of the systemic inflammatory response ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Obstetric Risk Factors and Serological Characteristics of Early-Onset Neonates Bacterial Infections

Wang

Chen²,

Xu³

et al. 2022

Front. Surg.

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PurposeTo analyze the obstetric high-risk factors and serological characteristics of early-onset neonatal bacterial infections (EONBI).Methods119 neonates with early-onset bacterial infection who were admitted to the neonatal ward of our hospital from October 2020 to December 2021 were recorded as the study group, and 100 neonates without bacterial infection who were admitted during the same period were used as the reference group. Comparative analysis of obstetric high-risk factors and serological characteristics of EONBI.ResultsThere was no statistical difference between the two groups in terms of gender and age at admission (P > 0.05). The gestational age and birth weight of newborns in the study group were lower than those in the reference group (P < 0.001). Comparing the maternal factors of EONBI between the two groups, there was no statistical difference in age, number of obstetric inspections, whether to use antibiotics, and mode of delivery (P > 0.05). Univariate analysis showed that preterm birth, unexplained asphyxia, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h were significantly associated with EONBI (P < 0.05); while there was no significant difference between the two groups in the comparison between diabetic mother and child and maternal fever at delivery (P > 0.05). Multifactorial analysis showed that preterm birth, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h had a good multivariate dependence on EONBI (P < 0.05), while there was no significant association with unexplained asphyxia, diabetic mother and child, and maternal fever at delivery (P > 0.05). The incidence of neonatal temperature >37.9°C was higher in the study group than in the reference group (P < 0.05), and there were no statistical differences in the comparison of other clinical manifestations (P > 0.05). The CRP level of neonates in the study group (47.33 ± 4.14) mg/L was higher than that of the reference group (4.84 ± 1.03) mg/L (P < 0.001). The WBC level of neonates in the study group (5.64 ± 1.18) 109/L was higher than that of the reference group (0.28 ± 0.04) 109/L (P < 0.001). The PCT level of neonates in the study group (5.41 ± 0.85) µg/L was higher than that of the reference group (0.24 ± 0.07) µg/L (P < 0.001).ConclusionEONBI is closely associated with several obstetric high-risk factors, including preterm birth, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h; EONBI has no specific symptoms and signs, but serum CRP, WBC, and PCT levels are significantly higher than those of newborns without co-infection with bacteria.

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Section: Discussionmentioning

confidence: 99%

Obstetric Risk Factors and Serological Characteristics of Early-Onset Neonates Bacterial Infections

Wang

Chen²,

Xu³

et al. 2022

Front. Surg.

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“…Detection of D-D: 1 Take the clever kit from the cold storage, equilibrate at room temperature for at least half an hour, add 1.1 mL of D-D gold standard lyophilized product to the lyophilized product of D-D gold standard solution and shake it well; 2 Lay the D-D reaction plate flat on the laboratory bench, and add 2 drops of D-D blocking solution to the reaction hole to make it completely infiltrate; 3 Use a sterile tip to absorb 100ul organic acid Add anticoagulant plasma to the reaction plate. After it is completely infiltrated, add 2 drops of D-D washing solution; 4 When the washing liquid is completely infiltrated, use a clean tip to accurately add 100ul of D-D colloidal gold solution; 5 After the infiltration is complete, add 4 drops of D-D washing solution; 6 Immediately read the absorbance (OD value) under the D-D item of the U2 gold standard quantifier, and calculate the D-D concentration in the sample.…”

Section: Methodsmentioning

confidence: 99%

“…More and more studies have shown that PCT levels in the blood of patients with bacterial infections will increase, especially in patients with severe bacterial infections or sepsis. 6 , 7 Therefore, in foreign clinical practice, PCT is often regarded as one of the sensitive indicators for the diagnosis of severe sepsis and is used in clinical diagnosis, treatment, and prognosis. The chelation of Fe 3+ with serum transferrin can transport free iron ions.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Fe3+ and Inflammation Indicators in the Death of Sepsis Patients: A Retrospective Study of 428 Patients

Jia¹,

Wang²,

Wei³

2021

TCRM

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“…8 Accuracy of serum PCT reference curves of serum PCT levels for neonates has recently been evaluated. 9 The serum PCT reference curves published by Fukuzumi et al were found to have the highest diagnostic accuracy. 10 For preterm infants, the PCT level alone with a cutoff value more than the 95th percentile in the serum PCT reference curve, and for term infants, the PCT level, and CRP level in combination with WBC count and/or IgM level should be used for the detection of early-onset bacterial infection.…”

Section: Serum Pctmentioning

confidence: 97%

Diagnostic Accuracy of Cord and Venous Blood Procalcitonin in Relation to Neonatal Sepsis Screen

Meena

Sharma

Bagri

et al. 2022

Journal of Neonatology

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Background: Neonatal sepsis is an important cause of neonatal deaths globally. Diagnosis of neonatal sepsis is established based on the clinical status of the newborn and microbiological tests of sepsis screen. Mid-phase markers of inflammation such as C-reactive protein (CRP) and serum procalcitonin (PCT) are considered useful and sensitive for early diagnosis. Most of the studies evaluating serum cord blood PCT as a diagnostic marker for neonatal septicemia have been carried out in peripheral venous blood with smaller sample sizes with the inclusion of neonates without considering perinatal sepsis scores (PSSs). Objective: To compare the diagnostic accuracy of cord blood PCT with venous blood PCT, alone and as part of sepsis screening parameters. Study Design: This hospital-based, prospective diagnostic accuracy study aimed to evaluate the diagnostic accuracy of serum PCT alone and in combination with other diagnostic modalities for the detection of early-onset neonatal sepsis in cord blood and to compare the diagnostic utility of PCT with neonatal sepsis screening parameters in venous blood and was conducted at a tertiary care center. Categorical/nominal variables were expressed as numbers and percentages and were analyzed using the chi-square test. The receiver–operating characteristic curve was drawn to determine the area under the curve (with a 95% confidence interval) for various parameters for the diagnosis of sepsis. Sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV), and diagnostic accuracy were calculated by using a 2 × 2 contingency table. All statistical analyses were done using SPSS trial version 20. Participants: A total of 247 newborns delivered with positive PSSs were enrolled. Intervention: In neonates with a positive PSS, cord blood serum PCT, sepsis screen, and blood culture were sent at the time of birth. They were observed for 72 hours for signs and symptoms suggestive of sepsis. Results: Statistical analysis of cord blood serum PCT for detecting blood culture-positive patients showed that PCT has a sensitivity of 44.4%, specificity of 86.4%, PPV of 33.3%, and NPV of 91.1%. Overall diagnostic accuracy is 80.9% indicating that cord blood PCT is a good test for identifying these patients ( p <.05). However, venous blood PCT failed to demonstrate similar results. Conclusion: Umbilical blood sampling protects neonates from the pain of venipunctures. Statistical comparison of cord blood PCT in relation to sepsis screen and/or blood culture and comparisons with the venous blood parameters in the same domains suggests better sensitivity and specificity than venous blood PCT. This early serological biomarker is valuable for early diagnosis and management while awaiting blood culture reports and helps in reducing the separation of neonates with suspected sepsis from their mother and thus helping in developmental supportive care.

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Diagnostic Accuracy of Biomarkers for Early-Onset Neonatal Bacterial Infections: Evaluation of Serum Procalcitonin Reference Curves

Cited by 8 publications

References 30 publications

Obstetric Risk Factors and Serological Characteristics of Early-Onset Neonates Bacterial Infections

Obstetric Risk Factors and Serological Characteristics of Early-Onset Neonates Bacterial Infections

The Diagnostic Value of Fe3+ and Inflammation Indicators in the Death of Sepsis Patients: A Retrospective Study of 428 Patients

Diagnostic Accuracy of Cord and Venous Blood Procalcitonin in Relation to Neonatal Sepsis Screen

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