A clinic-biological score for diagnosing early-onset neonatal infection in critically ill preterm infants*

Labenne, M.; Lizard, Gérard; Ferdynus, Cyril; Montange, Thierry; Iacobelli, Simona; Bonsante, Francesco; Gouyon, Jean‐Bernard

doi:10.1097/pcc.0b013e3181e2a53b

Cited by 12 publications

(25 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to these findings Jung et al ( 38 ), pointing to the fact that LOS has been observed in infants born with FIRS after an initial period of clinical improvement, suggested that the anti-inflammatory response might play an important role in the development of LOS. Increased concentrations of anti-inflammatory cytokines like IL-10 measured in infected infants ( 42 , 49 ) proof the activation of an anti-inflammatory immune response and support this theory ( 38 ).…”

Section: Diagnosis Of Neonatal Sepsismentioning

confidence: 79%

“…None of the widespread laboratory markers of infection [C reactive protein (CRP), white blood cell count (WBC), absolute neutrophil count (ANC), immature to total neutrophil ratio (IT-ratio)] has enough sensitivity or specificity to detect all infected children ( 17 , 49 ). Their diagnostic value might be especially limited in the early course of the disease ( 49 ). CRP, for example, is known to rise not earlier than 12–24 h after the onset of neonatal infection ( 2 ).…”

Section: Diagnosis Of Neonatal Sepsismentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers

Eichberger

Resch

2022

Front. Pediatr.

View full text Add to dashboard Cite

This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk factors influence the results of inflammatory markers as do gestational age, the time of sampling, the use of either cord blood or neonatal peripheral blood, and some non-infectious causes. Current evidence suggests that the use of promising diagnostic markers such as CD11b, CD64, IL-6, IL-8, PCT, and CRP, either alone or in combination, might enable clinicians discontinuing antibiotics confidently within 24–48 h. However, none of the current diagnostic markers is sensitive and specific enough to support the decision of withholding antibiotic treatment without considering clinical findings. It therefore seems to be justified that antibiotics are often initiated in ill term and especially preterm infants. Early markers like IL-6 and later markers like CRP are helpful in the diagnosis of neonatal sepsis considering the clinical aspect of the neonate, the gestational age, maternal risk factors and the time (age of the neonate regarding early-onset sepsis) of blood sampling.

show abstract

Section: Diagnosis Of Neonatal Sepsismentioning

confidence: 79%

Section: Diagnosis Of Neonatal Sepsismentioning

confidence: 99%

Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers

Eichberger

Resch

2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…We found 19 articles which were eligible for inclusion in our review [61,[70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87]. Papers were published between 1995 and 2014.…”

Section: Methodological Quality Of the Included Studiesmentioning

confidence: 99%

“…In view of the latest advances in neonatal care, these reference intervals derived from only 35 near-term and 113 term newborns need additional refinement in a larger sample of healthy neonates including, in particular, those born before 35 weeks of gestation, that is, those that now populate most NICUs [61]. term used was: (Interleukin-6 OR IL-6) AND (neonatal sepsis OR neonatal infection OR sepsis).…”

Section: Il-6 Reference Intervals and Dynamics In The Early Postnatalmentioning

confidence: 99%

Fetal and early neonatal interleukin-6 response

et al. 2015

View full text Add to dashboard Cite

In 1998, a systemic fetal cytokine response, defined as a plasma interleukin-6 (IL-6) value above 11 pg/mL, was reported to be a major independent risk factor for the subsequent development of neonatal morbid events even after adjustments for gestational age and other confounders. Since then, the body of literature investigating the use of blood concentrations of IL-6 as a hallmark of the fetal inflammatory response syndrome (FIRS), a diagnostic marker of early-onset neonatal sepsis (EONS) and a risk predictor of white matter injury (WMI), has grown rapidly. In this article, we critically review: IL-6 biological functions; current evidence on the association between IL-6, preterm birth, FIRS and EONS; IL-6 reference intervals and dynamics in the early neonatal period; IL-6 response during the immediate postnatal period and perinatal confounders; accuracy and completeness of IL-6 diagnostic studies for EONS (according to the Standards for Reporting of Diagnostic Accuracy statement); and recent breakthroughs in the association between fetal blood IL-6, EONS, and WMI.

show abstract

“…During full‐text screening, 48 publications were excluded because of: theoretical research, lack of clinical outcomes, and duplicate articles . Therefore, a final total of 31 studies were used for the current meta‐analysis, of which 1448 neonates were studied and evaluated in the sepsis group and 1628 neonates in the no‐sepsis group (see Figure ). Table shows the major characteristics of the selected studies.…”

Section: Resultsmentioning

confidence: 99%

A meta‐analysis of interleukin‐6 as a valid and accurate index in diagnosing early neonatal sepsis

Sun

Liang

et al. 2019

International Wound Journal

View full text Add to dashboard Cite

We aimed to systematically assess the overall value of interleukin 6 (IL‐6) in diagnosing neonates with sepsis. A systematic literature search was conducted using the following electronic databases: PubMed, Embase, and Cochrane, to identify eligible studies through the index words updated till November 2018. Cross‐sectional studies, as well as prospective cohort studies, were included in the above‐mentioned group of eligible studies. We also searched the literature sources that had a link to the present study, which were further assessed by heterogeneity through the use of a proper‐effects model to calculate pooled weighted specificity, sensitivity, and diagnostic odds ratio (DOR). We also conducted summary receiver operating characteristic (SROC) analyses for neonatal sepsis. In the present meta‐analysis, there were 31 studies exploring IL‐6 for the diagnostic accuracy of neonatal sepsis. The global specificity and sensitivity of IL‐6 for neonatal sepsis were as follows: 88% (95% confidence interval [CI]: 83%‐92%) and 82% (95% CI: 77%‐86%), respectively. The global positive and negative likelihood ratio of IL‐6 in diagnosing neonatal sepsis were 7.03 (95% CI: 4.81‐10.26) and 0.20 (95% CI: 0.15‐0.26), respectively. The global DOR was 29.54 (95%CI: 18.56‐47.04) of IL‐6. In addition, the area under the SROC was high for IL‐6 (AUC = 0.92; 95% CI: 0.89‐0.94). In this study, we performed a systematic review and meta‐analysis to assess the diagnostic accuracy studies of IL‐6 in diagnosing neonatal sepsis. Our results suggested that IL‐6 is a valid and accurate index in diagnosing early neonatal sepsis, but it still needs to be combined with other laboratory tests and specific clinical manifestations.

show abstract

A clinic-biological score for diagnosing early-onset neonatal infection in critically ill preterm infants*

Abstract: A predictive model combining serum IL-6 and IL-8 measurements and selected clinical variables could distinguish infected from noninfected preterm infants at birth and should help the clinician in reducing or shortening the unnecessary use of antibiotics.

Cited by 12 publications

References 41 publications

Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers

Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers

Fetal and early neonatal interleukin-6 response

A meta‐analysis of interleukin‐6 as a valid and accurate index in diagnosing early neonatal sepsis

Contact Info

Product

Resources

About