How accurate are leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis?

O, da Silva; Ohlsson, Arne

doi:10.1093/pch/3.3.158

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…maternal fever, rupture of membranes, etc.) [26–28, 60], signs of neonatal sepsis and laboratory tests, such as neonatal WBC and differential counts [61–80], an immature to mature ratio of neutrophils [77, 80–83], interleukin (IL)-6 [84–118], IL-8 [81, 91, 100, 101, 104, 106, 109, 113, 119], C-reactive protein (CRP) [68–70, 72, 78, 103, 104, 113, 118, 120–125], procalcitonin [118, 123, 124, 126–128], blood [26, 30, 82, 129–134], and cerebro-spinal fluid cultures [135–144] as well as other biomarkers. Despite intensive investigation, the accurate identification of early-onset sepsis in neonatology remains a conundrum [26–28, 32, 34, 145].…”

Section: Introductionmentioning

confidence: 99%

Clinical chorioamnionitis at term VI: acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity

Romero¹,

Chaemsaithong²,

Docheva³

et al. 2015

Journal of Perinatal Medicine

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Objective Neonates born to mothers with clinical chorioamnionitis at term are at an increased risk of infection. Acute subchorionitis, chorioamnionitis, and funisitis are considered placental histologic features consistent with acute inflammation according to the Society for Pediatric Pathology. The objectives of this study were to examine the performance of placental histologic features in the identification of: 1) microbial-associated intra-amniotic inflammation (intra-amniotic infection); and 2) a fetal inflammatory response syndrome (FIRS). Methods and Materials This retrospective cohort study included women with the diagnosis of clinical chorioamnionitis at term (n=45), who underwent an amniocentesis to determine: 1) the presence of microorganisms using both cultivation and molecular biologic techniques [polymerase chain reaction (PCR) with broad range primers]; and 2) interleukin (IL)-6 concentrations by enzyme-linked immunosorbent assay (ELISA). The diagnostic performance (sensitivity, specificity, accuracy, and likelihood ratios) of placental histologic features consistent with acute inflammation was determined for the identification of microbial-associated intra-amniotic inflammation and FIRS. Results 1) The presence of acute histologic chorioamnionitis and funisitis was associated with the presence of proven intra-amniotic infection assessed by amniotic fluid analysis; 2) funisitis was also associated with the presence of FIRS; 3) the negative predictive value of acute funisitis ≥ stage 2 for the identification of neonates born to mothers with intra-amniotic infection was less than 50%, and therefore, suboptimal to exclude fetal exposure to bacteria in the amniotic cavity; and 4) acute funisitis ≥ stage 2 had a negative predictive value of 86.8% for the identification of FIRS in a population with a prevalence of 20%. Conclusion Acute histologic chorioamnionitis and funisitis are associated with intra-amniotic infection and the presence of FIRS. However, current pathologic methods have limitations in the identification of the fetus exposed to microorganisms present in the amniotic cavity. Further studies are required to determine whether molecular markers can enhance the performance of placental pathology in the identification of neonates at risk for neonatal sepsis.

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Section: Introductionmentioning

confidence: 99%

Clinical chorioamnionitis at term VI: acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity

Romero¹,

Chaemsaithong²,

Docheva³

et al. 2015

Journal of Perinatal Medicine

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“…The accuracy of blood cultures is questionable owing to the occurrence of either a spurious result from contamination or negative blood culture in the face of a fatal systemic bacterial infection. 2,4 A blood culture result can be delayed by up to 48 hours with an inconsistent positivity rate in the range of 10-87%. 2,5 This has led to use of other surrogate markers of infection as tools to support or refute the early diagnosis of neonatal sepsis.…”

Section: Introductionmentioning

confidence: 99%

“…The commonly used markers include complete blood count (CBC) with various neutrophil parameters and CRP. 2,4 Being an acute-phase reactant, synthesis of CRP by the liver increases more than 1000-fold in response to pro-inflammatory cytokines. 6 Whether as a single or serial measurement, many studies report CRP to be a useful test to support or refute the diagnosis of neonatal sepsis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating theQuikRead®C-reactive protein test as a point-of-care test

Diar

Nakwa

Thomas

et al. 2012

Paediatrics and International Child Health

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Blood culture indications in critically ill neonates: a multicenter prospective cohort study

et al. 2018

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Center heterogeneity in sampling practice is substantial. Optimizing sampling practice can be recommended. What is Known: • Blood culture test is a common diagnostic procedure in critically-ill newborns. • A low threshold for sampling and antimicrobial therapy initiation is accepted. What is New: • Variability in blood culture practice was assessed between 3 neonatal intensive care units by the registration of sampling frequencies, clinical indications, and antimicrobial therapy initiation.

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How accurate are leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis?

Cited by 3 publications

References 18 publications

Clinical chorioamnionitis at term VI: acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity

Clinical chorioamnionitis at term VI: acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity

Evaluating theQuikRead®C-reactive protein test as a point-of-care test

Blood culture indications in critically ill neonates: a multicenter prospective cohort study

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