Etiological profile of early neonatal bacterial sepsis by multiplex qPCR

Silva-Junior, Walter P; Martins, Almir de Sousa; Xavier, Paula Cristhina Niz; Appel, Kelly L A; Oliveira, S. A.; Palhares, Durval Batista

doi:10.3855/jidc.7474

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…According to Vergano et al, the infections with negative cultures are the most frequent ones, and can be confirmed in less than 1% of the cases. 25 Other studies found a positivity rate of 2.3 17 , 3.0 26 and 4.6%. 27 The optimization of the laboratory diagnosis requires fast tests, with better sensitivity and high specificity, which still do not exist.…”

Section: Discussionmentioning

confidence: 94%

“…A Brazilian study that used universal primer (q-CRP) showed positivity in all patients diagnosed with clinical sepsis, and in 97% of the studied patients, the DNA of one or more among the seven analyzed bacteria was found. 26 A remark for these tests is that the positive result can represent only one contamination, and, if performed in patients without any clinical indication, it would possibly lead to excessive treatment indications.…”

Section: Discussionmentioning

confidence: 99%

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Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

Camargo¹,

Caldas

Marba

2022

Rev. paul. pediatr.

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Objective: To analyze the incidence, complications, and hospital discharge status in newborns with ≥35 weeks of gestational age with early neonatal sepsis. Methods: This is a cross-sectional, retrospective study. Cases of early-onset sepsis registered from January 2016 to December 2019 in neonates with gestational age of 35 weeks or more were reviewed in a level III neonatal unit. The diagnoses were performed based on the criteria by the Brazilian Health Regulatory Agency (Anvisa), and the episodes were classified according to microbiological classification and site of infection. The following complications were evaluated: shock, coagulation disorders, and sequelae of the central nervous system. The conditions at hospital discharge were also assessed. The collected data were analyzed with the descriptive analysis. Results: In the period, early neonatal sepsis occurred in 46 newborns, corresponding to 1.8% of all newborns admitted to the neonatal unit, with a prevalence of 4/1,000 live births. Culture confirmed sepsis ocurred in three patients (0.3/1,000 live births), with the following agents: S. pneumoniae, S. epidermidis and S. agalactiae. As to site of infection, there were 35 cases of primary bloodstream infection, seven cases of pneumonia and four cases of meningitis. Most patients (78.3%) had at least one risk factor for sepsis, and all were symptomatic at admission. There were no deaths. Complications occurred in 28.2% of the cases, especially shock (10 cases – 21.7%). Conclusions: The prevalence of proven early neonatal sepsis was low. Despite the common occurrence of complications, there were no deaths.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

Camargo¹,

Caldas

Marba

2022

Rev. paul. pediatr.

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“…Conventional microbiological methods may frequently fail to identify pathogens because of technical issues or traits intrinsic to microorganisms that limit sepsis detection. Although new diagnostic approaches have been developed to replace conventional methods, implementation in developing countries will be challenging because of a lack of resources [31,32].…”

Section: Discussionmentioning

confidence: 99%

Clinical and bacteriological profile of culture-negative and culture-proven neonatal sepsis in Palembang, Indonesia

Karmila

Barchia

Ramandati

et al. 2022

J Infect Dev Ctries

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Introduction: Culture-negative and multidrug-resistant neonatal sepsis frequently occur in developing countries and complicate neonatal sepsis management. These conditions contribute to a high neonatal mortality rate and accelerate the misuse of antibiotics. However, the extent of culture-negative and multidrug-resistant neonatal sepsis in developing countries remains poorly characterized. This study aims to describe culture-negative and culture-proven neonatal sepsis epidemiology and the antimicrobial resistance patterns in Palembang, Indonesia. Methodology: A retrospective review of the medical records of all neonatal admissions between January 2016 and December 2018 was conducted at a tertiary-level referral hospital in Indonesia. The maternal and neonatal characteristics and microbiological results of the identified sepsis cases were obtained and analyzed. Results: Three hundred and fifty-six neonatal sepsis cases were admitted from 2016 to 2018, accounting for 14.1% of neonatal hospital admissions. The percentages of early-onset and late-onset sepsis were comparable (49.7% vs. 50.3%), with an 18.1% case fatality rate. The proportion of culture-negative sepsis was 44%. The mortality rates between culture-proven and culture-negative sepsis cases did not differ statistically (p = 0.11). Coagulase-negative staphylococci (30.9%), Klebsiella pneumoniae (18.1%), and Acinetobacter spp. (10.7%) were the most frequently isolated pathogens. Overall, 62.6% of all isolated organisms were multidrug-resistant bacteria, with a high prevalence of extended-spectrum cephalosporin-resistant and carbapenem-resistant strains. Conclusions: Culture-negative sepsis accounts for a significant proportion of neonatal sepsis cases. Early- and late-onset and culture-negative and culture-proven neonatal sepsis contribute to a comparable proportion of neonatal sepsis morbidity and mortality. There is an alarmingly high prevalence of resistance to extended-spectrum cephalosporin and carbapenem in neonatal sepsis cases.

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“…EL-Amir et al 15 demonstrated a prevalence of Gram-negative bacteria among patients with EONS but they found that the most common Gram-negative bacteria causing EONS was E.coli. Also, Silva-Junior et al 34 showed that E. coli, Staphylococcus aureus, and Streptococcus agalactiae were the main causative organisms of EONS.…”

Section: Discussionmentioning

confidence: 99%

Automated Blood Culture versus Amplification of 16S rRNA Gene Method for Detection of Neonatal Septicemia

Abdelmoneim

2021

Egyptian Journal of Medical Microbiology

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Background: Accurate and rapid diagnosis of neonatal septicemia is highly warranted because of high associated morbidity and mortality. Blood culture serves as a routine method for diagnosis of bacterial sepsis. However, it sometimes takes ≥ 72 hours for the results, with low sensitivity. Full automated blood culture method is superior to conventional methods in terms of speed and sensitivity. The polymerase chain reactionbased detection of 16S rRNA has reduced the laboratory turnaround time and has good sensitivity. Objectives: The aim of this study was to compare automated blood culture and amplification of 16srRNA gene by PCR in detection of aerobic bacterial infection in blood samples of hospitalized neonates with suspected neonatal sepsis and to determine the most common types of bacteria causing neonatal sepsis. Methodology: Blood samples collected from 40 neonates clinically suspected as neonatal sepsis were subjected to bacterial identification through automated blood culture by BacT/ALERT PF Plus Culture Bottles, and bacterial detection of 16S rRNA gene by PCR. Results: Out of 40 neonatal blood samples with suspected sepsis, 37(92.5%) neonates showed concordance between automated blood culture and PCR; 17(42.5%) showed positive results while 20 (50%) gave negative results by both methods. The remaining 3 cases (7.5%) were positive only by PCR. PCR sensitivity, specificity, positive and negative predictive values were 100%, 86.9%, 85% and 100% respectively. So, accuracy of PCR in relation to automated blood culture is 92.5%. The most common pathogens in cases of early onset neonatal sepsis were Klebsiella pneumoniae (7/15, 46.7%) followed by Streptococcus agalactiae (1/15, 6.6%) while the most common pathogens found in cases of late onset neonatal sepsis were Klebsiella pneumoniae and coagulase negative staphylococci (4/25,16% for each) then Staphylococcus aureus (1/25, 4%). Conclusion: 16S rRNA PCR showed accurate rapid diagnosis with higher sensitivity in diagnosis of neonatal septicemia. Klebsiella peumoniae was the main causative bacteria in early onset neonatal sepsis and late onset neonatal sepsis.

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Etiological profile of early neonatal bacterial sepsis by multiplex qPCR

Cited by 12 publications

References 24 publications

Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

Clinical and bacteriological profile of culture-negative and culture-proven neonatal sepsis in Palembang, Indonesia

Automated Blood Culture versus Amplification of 16S rRNA Gene Method for Detection of Neonatal Septicemia

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