Diagnostic markers for neonatal sepsis

Ng, Pak Cheung; Lam, Hugh Simon

doi:10.1097/01.mop.0000193293.87022.4c

Cited by 165 publications

(161 citation statements)

References 47 publications

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“…1 Early warning signs and symptoms of neonatal sepsis are often nonspecific and subtle especially at the onset of infection, and can easily be confused with other common noninfectious causes. 2 The incidence of sepsis ranges from 1 to 10 cases in every 1000 live births, with high mortality rates despite antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

et al. 2008

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Objective: The purpose of this study was to determine the role of serum amyloid A (SAA) in diagnosis of neonatal sepsis and evaluation of clinical response to antibiotic therapy. We also aimed to compare the efficiency of SAA with that of C-reactive protein (CRP) and procalcitonin (PCT) in diagnosis and follow-up of neonatal sepsis in preterm infants.Study Design: A total of 163 infants were enrolled in this prospective study. The infants were classified into four groups: group 1 (high probable sepsis), group 2 (probable sepsis), group 3 (possible sepsis) and group 4 (no sepsis, control group). Blood samples for whole blood count, CRP, PCT, SAA and culture were obtained before initiating antibiotic treatment. This procedure was repeated three times at 48 h, 7 and 10 days.Result: Initial CRP, PCT and SAA levels were found to be positive in 73.2, 75.6 and 77.2% of all infants, respectively. Sensitivities of CRP, PCT and SAA at 0 h were 72.3, 74.8 and 76.4%, respectively. Although it was not statistically significant, SAA was found to be more sensitive than CRP and PCT in diagnosis of neonatal sepsis. The area under the curve (AUC) for CRP, PCT and SAA at 0 h were 0.870, 0.870 and 0.875, respectively. Although the AUC for SAA at 0 h was higher than PCT and CRP, the difference was not statistically significant. Conclusion:SAA is an accurate and reliable marker for diagnosis and follow-up of neonatal sepsis. It is especially useful at the onset of inflammation for rapid diagnosis of neonatal sepsis and can be safely and accurately used in combination with other sepsis markers such as CRP and PCT in diagnosis and follow-up of neonatal sepsis in preterm infants.

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Section: Introductionmentioning

confidence: 99%

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

et al. 2008

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“…5 Early diagnosis of LOS in preterm infants may be challenging because of the questionable accuracy and latency of blood culture, and the best single biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6, interleukin-8, or their combination has not been identified. [6][7][8][9][10] Therefore, it was recently suggested that additional studies are necessary to identify more accurate biomarkers of neonatal sepsis. 8 Presepsin (P-SEP), or soluble CD14 subtype, is a trunked portion of soluble CD14, which is released by shedding from the surface of various immune cell lines, such as macrophages, monocytes, and neutrophils, after its stimulation by pathogens.…”

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confidence: 99%

Presepsin for the Detection of Late-Onset Sepsis in Preterm Newborns

Poggi,

Bianconi,

Gozzini

et al. 2015

Pediatrics

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BACKGROUND: Late-onset sepsis (LOS) is among the leading causes of morbidity and mortality in preterm newborns, and currently available diagnostic tools are inadequate. The objective of this study was to evaluate the accuracy of presepsin (P-SEP) as novel biomarker of bacterial infection for the diagnosis of LOS in preterm newborns. METHODS:We prospectively studied newborns #32 weeks' gestational age with LOS (n = 19) and noninfected controls (n = 21) at 4 to 60 days' postnatal age. At enrollment, and 1, 3, and 5 days later, we ascertained the C-reactive protein, procalcitonin, and P-SEP in the LOS group, whereas P-SEP alone was ascertained in the control group.RESULTS: P-SEP at enrollment was higher in the LOS than the control group (median 1295 vs 562 ng/L, P = .00001) and remained higher throughout the study period. In the LOS group, P-SEP had a borderline reduction at day 1 versus values at enrollment (median 1011 vs 1295 ng/L, P = .05), whereas C-reactive protein and procalcitonin at day 1 did not differ from baseline values. The receiver operating characteristic curve of P-SEP at enrollment shows an area under the curve of 0.972. The best calculated cutoff value was 885 ng/L, with 94% sensitivity and 100% specificity. Negative likelihood ratio was 0.05, and positive likelihood ratio was infinity. CONCLUSIONS:We demonstrated for the first time in a cohort of preterm newborns that P-SEP is an accurate biomarker for the diagnosis of possible LOS and may also provide useful information for monitoring the response to therapeutic interventions. WHAT'S KNOWN ON THIS SUBJECT:Early diagnosis of LOS in preterm infants may be challenging because of the questionable accuracy of blood culture and the common markers of infections, such as C-reactive protein and procalcitonin. WHAT THIS STUDY ADDS:Our study demonstrated for the first time that P-SEP is an accurate biomarker for the diagnosis of LOS in preterm infants and might contribute to the monitoring of infant response to therapeutic interventions.

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“…Может экспрессироваться на гранулоцитах после активации клеток цитокинами, такими как интерфе-рон-гамма и гранулоцитарный колониестимулирую-щий фактор [31,32]. Наличие CD64 на поверхности нейтрофилов является признаком инфекции и сепсиса [27,33,34]. Метаанализы по клиническому примене-нию данного маркера продемонстрировали уровни его чувствительности и специфичности 85 и 76 % соответ-ственно [35,36].…”

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