Immunologic markers in the neonatal period: diagnostic value and accuracy in infection

Kafetzis, Dimitris A.; Tigani, Georgia S; Costalos, Christos

doi:10.1586/14737159.5.2.231

Cited by 6 publications

(4 citation statements)

References 96 publications

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“…19 In many studies sensitivity of PCT in the diagnosis of neonatal sepsis was found to be 83-100% while the specificity ranged from 70-100%. 19,20 In our study, sensitivity of PCT was 90.9% and specificity was 100% which was found to be superior to CRP having 59.1% sensitivity and 81.25% specificity.…”

Section: Discussionmentioning

confidence: 45%

Is Procalcitonin a Better Diagnostic Marker Than CRP in Neonatal Sepsis?

Kumar¹,

Dayal²,

Agrawal³

et al. 2014

jemds

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OBJECTIVES:To study the diagnostic value of Procalcitonin (PCT) as compared to Creactive protein (CRP) in the diagnosis of neonatal sepsis. METHODS: This cross sectional study was conducted on 58 neonates in study and 16 in control group admitted in NICU, SN Medical College, Agra. Study group were divided into 2 groups viz. culture positive sepsis and culture negative sepsis. Blood culture, C -reactive protein, Procalcitonin and other investigations for sepsis were performed in all the subjects. RESULTS: PCT levels was raised in significantly higher number of 87.9% of study cases (87.9%) as compared to CRP which was positive in 55.2% (p=0.0002). The sensitivity, specificity and positive predictive value (PPV) of PCT in detecting sepsis was 100 %, 90.09%, 100 % respectively as compared to CRP having sensitivity, specificity, PPV as 81.3%, 59.1% and 81.3% respectively. PCT was a significantly better diagnostic marker in preterm (p=0.001), low birth weight newborns (p=0.0002) and in early onset sepsis (p=0.0007) in comparison to CRP. CONCLUSION: Serum level of PCT is a more reliable marker than CRP in the diagnosis of neonatal sepsis especially in preterm (<37 wk. gestation), low birth weight (<2.5 kg) newborns and early onset sepsis (<72 hrs. of life).

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Section: Discussionmentioning

confidence: 45%

Is Procalcitonin a Better Diagnostic Marker Than CRP in Neonatal Sepsis?

Kumar¹,

Dayal²,

Agrawal³

et al. 2014

jemds

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show abstract

“…However, there is a concern that inflammatory mediators may not perform as accurately during the immediate newborn period in detecting early onset sepsis since levels may be confounded by maternal factors, perinatal complications and severity of infection [97,98]. In one study, different cutoff points for CRP, IL-6 and PCT were used within the first 48 hours of life to improve sensitivities, with PCT superior to CRP or IL-6 [98].…”

Section: The Use Of Inflammatory Mediators In the Evaluation Of Febrimentioning

confidence: 99%

Neonatal Fever in the Term Infant: Evaluation and Management Strategies

Myers

Beck²,

Brummel

2008

CPR

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The presence of fever in the neonatal period demands urgent evaluation from healthcare providers since signs and symptoms of a serious bacterial infection in this age group can be nonspecific. Current practice guidelines recommend that febrile neonates should be presumed to have a serious bacterial infection and undergo a sepsis evaluation and hospitalization until the results of diagnostic testing are known. However, less than 50% of outpatient practitioners in a recent study followed these recommendations without apparent adverse outcomes even though the rate of serious bacterial infections in the neonatal period is higher than febrile infants 1-3 months of age. In this article we examine various clinical scenarios that healthcare providers confront when caring for febrile neonates, including whether febrile neonates with respiratory syncytial virus are at increased risk for developing a serious bacterial infection and whether diagnostic testing and empiric antiviral therapy for herpes simplex virus should be part of the standard evaluation of febrile neonates. Although the discovery of inflammatory mediators that are elevated during the early stages of infection has the potential to improve diagnostic capabilities in this age group, there is enough evidence to support international guidelines recommending hospitalization and sepsis evaluations in febrile neonates.

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“…This pro-inflammatory response does not depend considerably on gestation and postnatal age of a child. Interleukin-8 content in the blood of both term and preterm newborns is reliably higher in case infectious diseases available as compared to neonates with non-infectious pathology [12].…”

Section: Introductionmentioning

confidence: 97%

Diagnostic Value Parameters of Acute Phase Reactances of Infectious-Inflammatory Process in Diagnostics of Early Neonatal Sepsis

Bezrukov

Колоскова

Vlasova

2018

EUREKA: Health Sciences

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An advanced progress of clinical neonatology in recent years has enabled to achieve considerable success in newborn management with due respect to both medical treatment and general care, especially in the group of neonates with low body weight at birth. At the same time, neonatal sepsis in the early period still predetermine sickness and mortality of newborns. Material and methods. Clinical-paraclinical indices with detection of diagnostic value of C-reactive protein and interleukins-6 and 8 were evaluated in 100 neonates with available susceptibility factors to early neonatal infection from mother’s side and clinical signs of organ dysfunction in neonates with precautions of generalized infectious-inflammatory process at the end of their first day of life. Results. The data obtained substantiate that low concentrations of IL-6 and IL-8 prevail, and therefore the mentioned mediators hardly can be used to verify early neonatal infection. In the majority of children C-reactive protein elevated the concentration of 10.0 mg/L which is traditionally considered to be a discriminant as to the verification of an infectious process in newborns. Conclusions. None of the clinical signs associated with infectious-inflammatory process in newborns in the first two days of their life enabled to verify reliably availability of systemic bacterial infection.

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Immunologic markers in the neonatal period: diagnostic value and accuracy in infection

Cited by 6 publications

References 96 publications

Is Procalcitonin a Better Diagnostic Marker Than CRP in Neonatal Sepsis?

Is Procalcitonin a Better Diagnostic Marker Than CRP in Neonatal Sepsis?

Neonatal Fever in the Term Infant: Evaluation and Management Strategies

Diagnostic Value Parameters of Acute Phase Reactances of Infectious-Inflammatory Process in Diagnostics of Early Neonatal Sepsis

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