Potential biomarkers for effective screening of neonatal sepsis infections: An overview

Chauhan, Nidhi; Tiwari, Sukirti; Jain, Utkarsh

doi:10.1016/j.micpath.2017.03.042

Cited by 119 publications

(147 citation statements)

References 90 publications

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“…The main consequence of the variability exemplified above is that the abuse of antibiotics occurs as a consequence of seeking to prevent mortality due to sepsis [22]; which reinforces the concept known historically, that the decision to administer or not antimicrobial, depends more on the clinical evolution and the identified picture, than on the result of the different biomarkers or diagnostic tools proposed for sepsis [23] [24].…”

Section: Discussionmentioning

confidence: 56%

Decrease in the Hospital Stay of Neonates with Suspected Nosocomial Sepsis with the Use of a Molecular Biology Technique

Reyna-Figueroa¹,

Rodríguez-Sánchez²,

Matsumoto³

et al. 2019

JBM

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Introduction: Diagnostic alternatives that allow microbial identification in blood, such as molecular biology; have shown utility in neonatal sepsis. Objective: To evaluate the impact of a Light Cycler SeptiFast test (LCSF) on days of hospital stay and the use of newborn (NB) antibiotics with suspected sepsis. Methods: We included NB with LCSF test and blood culture (cases) and NB with only blood culture (controls). We evaluated the days of stay, days of antimicrobial use and number of deaths. Statistic analysis: Descriptive statistics was used. The association between the use of LCSF and variables such as mortality, days of stay, use of antimicrobials, and use of mechanical ventilation was analyzed by odds ratio with 95% CI. Results: We included 20 subjects in the case group and 40 in the control group. 8 (40%) of the cases were positive vs 6 (15%) of the controls in the control group. In the controls, the average days of stay were 65 + 15 vs 35 + 10 days of the cases (p < 0.05). There was no significant difference in mortality, nor in antimicrobial use. The use of molecular biology was a protective factor for prolonged stay OR 0.2 (95% CI 0.08 -0.5) p = 0.001. Conclusions: The LCSF test influences the days of hospital stay, but does not impact mortality or the use of antimicrobials.

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Section: Discussionmentioning

confidence: 56%

Decrease in the Hospital Stay of Neonates with Suspected Nosocomial Sepsis with the Use of a Molecular Biology Technique

Reyna-Figueroa¹,

Rodríguez-Sánchez²,

Matsumoto³

et al. 2019

JBM

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“…The probability of sepsis can be guided by pre-antibiotic initiation blood culture, full blood count (FBC), serial CRP, and procalcitonin (PCT) [64][65][66]. Blood culture and FBC are the most common and standard diagnostic measure for EOS in the most center [67].…”

Section: Discussionmentioning

confidence: 99%

“…CRP is a widely used biomarker with high specificity but low sensitivity because it also rises with non-infectious event; hence, it cannot be used alone [65,70]. Serial CRP at 24 h and 48 h can be helpful to assist decision-making whether to continue antibiotic despite sterile blood culture and normal FBC [31,71,72].…”

Section: Discussionmentioning

confidence: 99%

A Review of Antibiotic Used in Suspected Early-Onset Neonatal Sepsis From Malaysian Perspective: Which Ones to Choose and How Long to Give?

Ibrahim¹,

Makmor‐Bakry

Ishak

et al. 2019

Asian J Pharm Clin Res

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Objective: Suspected early-onset sepsis is a common diagnosis among neonates which warrants admission to the neonatal intensive care unit. Prolonged empiric antibiotic is the biggest concern and treatment duration is still controversial. Antimicrobial stewardship (AMS) program promotes early antibiotic de-escalation to reduce unnecessary antibiotic exposure and its implementation in the intensive care setting seems to be feasible. The primary objective of this review was to compare the existing guidelines and review the literature regarding choice and duration of empiric antibiotic in managing suspected early-onset neonatal sepsis.Methods: Two Malaysian Ministry of Health guidelines were compared with guidelines from America (n=1), Australia (n=1), and United Kingdom (n=2). The literature search was conducted from January to June 2017 through open access journal and databases available at the author’s institution library (EBSCOHost, Ovid and Science Direct).Results: All guidelines recommended similar antibiotics range and suggested to review treatment at 36– 72 h post antibiotic exposure. A total of 113 abstracts and full articles were identified, and only 11 full-text articles published in English were related to the subject of interest. All studies show differences either in study design, choice of antibiotics, treatment duration or outcome measures; thus, a meta-analysis was not possible to be conducted.Conclusion: From this review, we found the potential to performed early empiric antibiotic de-escalation especially in clinically well-appearance neonates, and it is best to customize our guidelines based on local evidence which justify the need for more local research in this area.

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“…It has the limitation of moderate sensitivity but has good negative predictive value. Other markers were having moderate sensitivity though direct towards diagnosis (Erythrocyte sedimentation rate, cytokines and interleukins (IL-6, IL-8, CD 11b) [48] but are not confirmative [49] IL-6 is reported to be a sensitive and specific indicator for the diagnosis of the NS due to PROM [49]. CRP and procalcitonin though are more specific there is no single confirmatory test; hence, a panel of test that includes haematological, biochemical assays, culture (blood, urine and cerebrospinal fluid) & sensitivity and radiological evaluation (chest, abdomen) is recommended.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Biomarkers of Neonatal Sepsis: Pro- Calcitonin Vs C-Reactive Protein

Akram

Naseem

2019

Int J Pediatr Res

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Background: Procalcitonin in neonatal sepsis (NS) has high sensitivity compared to C-reactive protein (CRP), but its specificity is not yet clearly defined. Objectives: Evaluation of Procalcitonin as an early marker, assessing its diagnostic utility in early-onset NS was the primary and comparing the levels of Procalcitonin with CRP was secondary objective. Method: In this observational, prospective study, neonates meeting the selection criteria were included and grouped into three, according to clinical symptoms of sepsis and blood culture. Results: Blood samples from 75 babies (male = 61.0%) were analysed; 63.0% and 37.0% were of gestational age (GA) ≥ 37 and < 37 and weeks, respectively. Birthweight <2.5 kg and >2.5 Kg was noted in 52.0% and 48.0%, respectively. Meconium stained liquor (n=34), premature rupture of membranes (n=19) and prolonged labour/instrumental delivery (n=13) were major maternal risk factors.General (45.33%), respiratory (25.33%), gastrointestinal (17.33%), cardiovascular (6.66%) symptoms were common presentation; forty one (55.0%) were negative for procalcitonin and 34 (45.0%) were positive; 61 (81.0%) tested negative for CRP, only 14 (19.0%) were positive with levels >10mg/mL. Procalcitonin positivity was statistically significant (<0.05) for males, term babies and with normal birth weight favouring procalcitonin. of seven positive blood culture, coagulase positive staphylococci (n= 03), Klebsiella(n= 02), E. coli (n=01), Pseudomonas (n=01) were isolated. On correlation with blood culture, Procalcitonin showed better sensitivity and negative predictive value. Conclusion: Procalcitoninis a better early marker than CRP in early onset NS. It hasbetter positivity for male, term and normal birth weight babies.

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Potential biomarkers for effective screening of neonatal sepsis infections: An overview

Cited by 119 publications

References 90 publications

Decrease in the Hospital Stay of Neonates with Suspected Nosocomial Sepsis with the Use of a Molecular Biology Technique

Decrease in the Hospital Stay of Neonates with Suspected Nosocomial Sepsis with the Use of a Molecular Biology Technique

A Review of Antibiotic Used in Suspected Early-Onset Neonatal Sepsis From Malaysian Perspective: Which Ones to Choose and How Long to Give?

Comparison of Biomarkers of Neonatal Sepsis: Pro- Calcitonin Vs C-Reactive Protein

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