Background As an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was thus designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases. Methods This cross-sectional study, which was carried out at the Paediatric Intensive Care Unit of Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia, had involved 60 neonates admitted for suspected sepsis. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and the area under receiver operating characteristics curve (AUC) for PCT were determined at initial presentation (0 h) as well as 12 h and 24 h after presentation in comparison to blood culture as the gold standard. Results The study consisted of 27 (45.0%) male and 33 (55.0%) female neonates with a mean (SD) age of 76.8 (48.25) h. At cut-off PCT value of > 2 ng/mL, the sensitivity, specificity, PPV and NPV were 66.7%, 66.7%, 33.3% and 88.9% at 0 h. The respective parameters were 83.3%. 56.3%, 32.3% and 93.1% at 12 h and 83.3%, 52.1%, 30.3% and 92.6% at 24 h. AUC was 71.6%, 76.6% and 71.7% at 0 h, 12 h and 24 h. Conclusions Diagnostic performance and discrimination values of PCT for diagnosis of neonatal sepsis varied with time of obtaining the blood samples. The PCT result at 12 h demonstrates the most optimal diagnostic performance and discrimination values.
Food contact surfaces may pose a threat of becoming vector for antimicrobial-resistant transmission of bacteria along the food chain. Twenty-four isolates of Escherichia coli were investigated to determine the antimicrobial resistance, production of Extended-Spectrum Beta-Lactamase Enzyme and their attachment ability on stainless-steel surface. The antimicrobial resistance and enzyme production tests were carried out according to standard disc diffusion assay, while attachment was simulated on stainless steel discs. All 24 isolates were resistant to Amoxycillin and Penicillin, while 50% and 37.5% were resistant to Ceftriaxone and Cefotaxime, respectively. Three of 24 isolates (12.5%) produced the enzyme against cefotaxime, ceftazidime and ceftriaxone. The enzyme production was further confirmed by the expansion of cefotaxime, ceftriaxone and ceftazidime inhibition zone towards amoxicillin-clavulanate disc. All 3 enzyme-producing isolates (EC-6, EC-7 and EC-12) exhibited their ability to attach to stainless-steel disc. Attachment was significantly increased (p<0.05) with prolonged incubation times with the highest attachment (6.07±0.05 log10 cfu/ml) by isolate EC-6 at 72h. The attachment ability indicates that resistant E. coli can be potentially transmitted into the food chain via contaminated food contact surfaces. Our data could be used to develop research to link the spread of antimicrobial resistance towards effective intervention strategies.
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