Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Miyosawa, Yukihide; Akazawa, Yohei; Kamiya, Motoko; Nakamura, Chizuko; Takeuchi, Yusuke; Kusakari, Mai; Nakamura, Tomohiko

doi:10.1111/ped.13469

Cited by 18 publications

(27 citation statements)

References 24 publications

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“…Although many studies have investigated predictors of SBI in young infants by implementing criteria or developing prediction models, [6][7][8] few studies have focused on using the vital signs, such as body temperature, pulse rate, and oxygen saturation. 9 One subgroup analysis of a systematic review showed that young infants with fever >40°C had a significantly high risk of SBI, 13 but no study has defined the cut-off point for each vital sign. The concept of systemic inflammatory response syndrome (SIRS) may be useful in this regard because SIRS is defined according to vital sign cut-offs.…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of this study was to determine whether abnormal vital sign parameters would be able to predict SBI in febrile young infants. An SBI was defined as a clinically diagnosed bacterial infection, such as bacterial meningitis, bacteremia, urinary tract infection (UTI), bacterial pneumonia, bacterial soft‐tissue infection, suppurative lymphadenitis, osteomyelitis, and bacterial enteritis, based on previous studies . Patients with bacterial meningitis, bacteremia, UTI or bacterial enteritis were diagnosed on detection of pathogens from specimens taken from the focus of the infection.…”

Section: Methodsmentioning

confidence: 99%

“…An SBI was defined as a clinically diagnosed bacterial infection, such as bacterial meningitis, bacteremia, urinary tract infection (UTI), bacterial pneumonia, bacterial soft-tissue infection, suppurative lymphadenitis, osteomyelitis, and bacterial enteritis, based on previous studies. [6][7][8][9] Patients with bacterial meningitis, bacteremia, UTI or bacterial enteritis were diagnosed on detection of pathogens from specimens taken from the focus of the infection. The diagnosis of bacterial pneumonia and osteomyelitis was based on the clinical manifestations and imaging.…”

Section: Clinical Outcomes and Definitionsmentioning

confidence: 99%

“…Many studies have investigated SBI predictors in febrile young infants to optimize patient care, but most of these studies involved laboratory examinations for white blood cell count, C‐reactive protein, and procalcitonin to diagnose SBI, requiring extensive use of medical resources . With the aim of optimizing the use of medical resources in the treatment of febrile young infants, some studies have reported using vital sign data to predict SBI, but these studies failed to include a precise cut‐off point for the variables, thus limiting the utility of their findings.…”

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confidence: 99%

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Predicting serious bacterial infection in febrile young infants utilizing body temperature

Nomura

Ihara

Sakakibara³

et al. 2019

Pediatrics International

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Background Febrile young infants have a high risk of serious infection. Although measuring vital sign parameters can serve as a rapid and effective assessment in these patients, their predictive value for serious bacterial infection (SBI) has not been fully investigated. Methods This retrospective observational study enrolled febrile (>38.0°C) infants aged <90 days at the time of presentation. Data from the emergency room triage database at Tokyo Metropolitan Children's Medical Center for the period 1 November 2011–30 November 2013, were reviewed. Variables included patient age, gender, and vital sign data, including body temperature, pulse rate, oxygen saturation, definitive diagnosis, and disposition. Results Two hundred and sixty‐nine patients were included, with a mean age of 55 days, and 158 (58.7%) were male. Of the total, 43 patients had an SBI. On logistic regression, body temperature ≥38.5°C (OR, 2.80; 95%CI: 1.37–5.74) was a significant predictor of SBI. Conclusion High‐grade fever was found to be a significant predictor of SBI in febrile young infants.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Clinical Outcomes and Definitionsmentioning

confidence: 99%

mentioning

confidence: 99%

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Predicting serious bacterial infection in febrile young infants utilizing body temperature

Nomura

Ihara

Sakakibara³

et al. 2019

Pediatrics International

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“…Um estudo de corte realizado em uma UTI neonatal sugere a existência de outros biomarcadores mais específicos que podem contribuir para o melhor diagnóstico do quadro infecioso. 24 É válido ressaltar que existem vários fatores que podem interferir nos resultados da hemocultura, dentre eles, a coleta que necessita de um local apropriado, volume adequado e momento da execução, além disso, a utilização preferencial de frascos pareados, bem como os procedimentos da fase analítica. Segundo as diretrizes para tratamento de sepse e choque séptico é indispensável realizar as hemoculturas antes de iniciar a antibioticoterapia empírica, devido a probabilidade de resultados falsos-negativos, pelo uso prévio de antibiótico.² As culturas negativas ou não realizadas trazem vários prejuízos ao paciente e ao hospital.…”

Section: Características Epidemiológicas E Clínicas Da Sepse Em Um Hounclassified

Características epidemiológicas e clínicas da sepse em um hospital público do Paraná

Zonta

Velasquez

et al. 2018

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. //dx.doi.org/10.17058/reci.v8i3.11438 Páginas 01 de 08 não para fins de citação Justificativa e Objetivos: A sepse é um problema de saúde pública que gera impacto clínico e econômico. O estudo objetiva descrever as características epidemiológicas e clínicas da sepse em um hospital público do Paraná. Métodos: Trata-se de uma pesquisa de campo exploratória, documental, retrospectiva, com abordagem quantitativa. Os dados foram coletados de prontuários de pacientes admitidos na Unidade de Terapia Intensiva adulto de janeiro de 2012 a janeiro de 2017, para isso utilizou-se um checklist com variáveis clínicas e demográficas. Foram inclusos todos os prontuários de pacientes internados no setor que apresentaram sepse no momento da internação ou desenvolvida após a admissão. Foi realizada análise de frequência descritiva, distribuição das variáveis independentes e significância pelo teste de Qui-quadrado.Resultados: De um total de 1.557 prontuários, foram incluídos 1112 (71,4%), os quais foram classificados com síndrome da resposta inflamatória sistêmica (13,9%), sepse (39,1 %) ou choque séptico (47,0 %). Houve predominância de pacientes do sexo masculino (55,8%), faixa etária maior de 70 anos (36,3%) e cor branca (92,6%). O tempo de internação foi de até uma semana (50,4%). Prevaleceram pacientes clínicos (42,4%), com infecção nosocomial encontrada em 50,2% dos casos. As principais fontes de infecção foram pulmão (32,9%) e ferida cirúrgica (23,5%). Entre as causas de admissão, complicações respiratórias (19,5%) e politrauma (9,3%) foram as mais frequentes. As culturas foram positivas em 29,7% dos casos, em sua maioria bacilos gram negativos (12,1%). A mortalidade na SIRS, na sepse e no choque séptico foi de 0,3%, 30,1%, 33,0%, respectivamente. Conclusão: O estudo evidenciou que a sepse acometeu em sua maioria idosos do sexo masculino, e que o foco infecioso foi de origem pulmonar em âmbito nosocomial. Observou-se ainda elevadas taxas de mortalidade, principalmente em casos de choque séptico. Descritores: Sepse. Unidade de Terapia Intensiva. Epidemiologia. Background and Objectives:Sepsis is a public health problem that causes clinical and economic impact. The objective of this study was to identify the epidemiological and clinical characteristics of sepsis in a public hospital. Methods: This is an exploratory field research, documental, retrospective, with quantitative approach. Data were collected from patients admitted to the Intensive Care Unit from January 2012 to January 2017, for which a checklist with clinical and demographic variables was used. We included all patients from hospitalized patients who had sepsis at the time of admission or after admission. Descriptive frequency analysis, Distribution of previous variables and significance were obtained by the Chi-square test. Results: Of a total of 1,557 medical records, 1112 (71,4%) were included in the study, whic...

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Presepsin for the Diagnosis of Neonatal Early-Onset Sepsis

et al. 2022

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IMPORTANCENeonatal early-onset sepsis (EOS) is a severe disease, particularly in preterm infants. Timely diagnosis can be challenging owing to unspecific presentation and questionable performance of the common markers of infection. Presepsin was recently proven to be a promising biomarker for the diagnosis of EOS. OBJECTIVE To assess presepsin accuracy for the diagnosis of EOS.DATA SOURCES PubMed Medline, EMBASE, Web of Science, and Google Scholar. No publication date restrictions were applied. The literature search was limited to the English language. Articles were checked for duplication.STUDY SELECTION Inclusion criteria were studies that (1) included term or preterm newborns (defined as newborns with gestational age Ն37 weeks or <37 weeks, respectively); (2) included a diagnosis of EOS, defined as culture-proven sepsis for primary analysis and as either clinical or culture-proven sepsis for secondary analysis; and (3) assessed presepsin values during the initial workup for suspected EOS. Exclusion criteria were studies that (1) did not include EOS cases; (2) lacked data on presepsin sensitivity and/or specificity; and (3) were case reports, commentaries, or reviews. Two independent reviewers performed the study selection.DATA EXTRACTION AND SYNTHESIS Two independent reviewers performed data extraction and quality assessment. Quality assessment was performed using the Quality Assessment for Studies of Diagnostic Accuracy 2 tool, and data were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe outcomes of interest for both the primary and secondary analyses were presepsin sensitivity, specificity, and diagnostic odds ratio for the diagnosis of EOS. RESULTS A total of 12 studies of 245 (4.9%) met inclusion criteria for the primary analysis. Twenty-three studies of 245 (9.4%) met the inclusion criteria for the secondary analysis. In the primary analysis, among 12 studies and 828 newborns of any gestational age, pooled sensitivity and specificity were 0.93 (95% CI, 0.86-0.95) and 0.91 (95% CI, 0.85-0.95), respectively; pooled diagnostic odds ratio was 131.69 (95% CI,. Subgroup analysis showed that presepsin specificity was associated with the inclusion of only EOS or all neonatal sepsis. Presepsin accuracy was not associated with gestational age, measurement with chemiluminescence enzyme immunoassay or enzyme-linked immunosorbent assay testing, country where the study was performed, or risk of bias judgment. In the secondary analysis, among 23 studies and 1866 newborns, accuracy was significantly associated with only test type. CONCLUSIONS AND RELEVANCEResults of this systematic review and meta-analysis suggest that presepsin was an accurate biomarker of EOS. Clinical trials are warranted to assess its usefulness and safety to reduce early antibiotic exposure, particularly in preterm newborns.

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Presepsin as a predictor of positive blood culture in suspected neonatal sepsis

Abstract: P-SEP can better discriminate between infections and non-infectious inflammatory conditions than the currently used biomarkers.

Cited by 18 publications

References 24 publications

Predicting serious bacterial infection in febrile young infants utilizing body temperature

Predicting serious bacterial infection in febrile young infants utilizing body temperature

Características epidemiológicas e clínicas da sepse em um hospital público do Paraná

Presepsin for the Diagnosis of Neonatal Early-Onset Sepsis

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