How Can the Microbiologist Help in Diagnosing Neonatal Sepsis?

Abstract

<jats:p>Neonatal sepsis can be classified into two subtypes depending upon whether the onset of symptoms is before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). These definitions have contributed greatly to diagnosis and treatment by identifying which microorganisms are likely to be responsible for sepsis during these periods and the expected outcomes of infection. This paper focuses on the tools that microbiologist can offer to diagnose and eventually prevent neonatal sepsis. Here, we discuss the advantages and limitation of the blood culture, the actual gold standard for sepsis diagnosis. In addition, we examine the utility of molecular techniques in the diagnosis and management of neonatal sepsis.</jats:p>

Prediction Models for Neonatal Health Care–Associated Sepsis: A Meta-analysis

“…[11][12][13] Blood culture is the gold standard test to diagnosis HABSI but prone to false-negative or false-positive results. [14][15][16] Blood cultures positive for coagulasenegative staphylococci or other skin commensals might represent falsepositive results due to contamination. Conversely, low blood culture volumes, which are a major issue in premature neonates, and previous antimicrobial therapy may be responsible for false-negative results.…”

Changing Trends in Bacterial Spectrum of Neonatal Sepsis at a Tertiary Care Teaching Hospital - 2011 to 2015

“…(14,15) Factors responsible for lower yield in blood culture in the presence of sepsis include inadequate volume of blood cultured, patients receiving antibiotics, inappropriate timing of culture, type of culture medium used, an inappropriate presumptive diagnosis and presence of other fastidious organisms or anaerobes. (14,16,17) The volume of blood that can be collected in a neonate cannot be increased, as it is difficult and unsafe to collect more than 1 mL of blood. (8,17) As per the hospital protocol, blood is sent for culture before initiating antibiotics, but as this is a tertiary care centre, some extramural neonates may have received antibiotics elsewhere before presenting to this hospital.…”

SOLUBLE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS -1 (sTREM-1) AS aDIAGNOSTIC AND PROGNOSTIC MARKER FOR LATE-ONSET SEPSIS IN PRETERM NEONATES.

“…It peaks 2 hours after infectious exposure where it can be measured in biological fluids providing an early marker for sepsis (Dupuy et al, 2013). Studies have reported increased levels of TREM-1 and sTREM-1 in the presence of infection while it is not up-regulated in patients with inflammatory conditions without infection so, it is useful for distinction between infectious and non-infectious diseases (Paolucci et al, 2012;Alqahtani et al, 2014).…”