Predictive Scores for Late-Onset Neonatal Sepsis as an Early Diagnostic and Antimicrobial Stewardship Tool: What Have We Done So Far?

Abstract

Background: Late-onset neonatal sepsis (LOS) represents a significant cause of morbidity and mortality worldwide, and early diagnosis remains a challenge. Various ‘sepsis scores’ have been developed to improve early identification. The aim of the current review is to summarize the current knowledge on the utility of predictive scores in LOS as a tool for early sepsis recognition, as well as an antimicrobial stewardship tool. Methods: The following research question was developed: Can we diagnose LOS with accuracy in neonates using a predictive score? A systematic search was performed in the PubMed database from 1982 (first predictive score published) to December 2021. Results: Some (1352) articles were identified—out of which, 16 were included in the review. Eight were original scores, five were validations of already existing scores and two were mixed. Predictive models were developed by combining a variety of clinical, laboratory and other variables. The majority were found to assist in early diagnosis, but almost all had a limited diagnostic accuracy. Conclusions: There is an increasing need worldwide for a simple and accurate score to promptly predict LOS. Combinations of the selected parameters may be helpful, but until now, a single score has not been proven to be comprehensive.

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

“…However, laboratory assessment is time- consuming and requires respective equipment. Therefore, the incorporation of clinical and readily available laboratory variables in a scoring model may be optimal ( 67 ).…”

Early Diagnosis of Late-Onset Neonatal Sepsis Using a Sepsis Prediction Score

“…The variety of the studies depicts the interest and the need for an easy-to-use and accurate scoring model. Some of these scores consisted exclusively of clinical variables [ 20 , 21 , 22 , 23 ], or only of laboratory variables [ 24 , 25 , 26 ], while others only used risk factors [ 27 ] and other combinations of these types of parameters [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Some of these studies analysed the changes of signs over time, as we also did in our study.…”

Utilising biosensor‐based approaches for identifying neurotropic viruses

“…Some individuals may have residual viral DNA or RNA in their CSF from a previous, resolved infection, leading to false‐positive results 26 . Furthermore, the sensitivity of CSF analysis can vary depending on the timing of the test in relation to symptom onset, making early diagnosis challenging 27 …”