Predictive Clinical Scores for Diagnosis of Late Onset Neonatal Septicemia

Singh, Surjit; Dutta, Sourabh; Narang, Anil

doi:10.1093/tropej/49.4.235

Cited by 48 publications

(66 citation statements)

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“…Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. 2 Due to these limitations we need to find parameters which will increase the sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Choudhary

Makwana

Mourya

et al. 2018

Int J Contemp Pediatr

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Background: Neonatal sepsis is major cause of neonatal morbidity and mortality worldwide. Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. Platelet indices are one such set of parameters which can be helpful in the future diagnosis of neonatal sepsis. This study was aimed to evaluate the significance of platelet indices either alone or in combination with existing sepsis screen as a marker of neonatal sepsis.Methods: Neonates admitted in the neonatal unit of Hospital and showing signs and symptoms of sepsis, and/or born to mothers with risk factor for sepsis were included in this study. Investigations sent for all these neonates included blood culture, sepsis screen (CRP, micro ESR, TLC, ANC, IT ratio) and platelet indices (Platelet count, MPV, PDW).Results: In present study, 81.12% neonates in case group had platelet count less than 1.5lacs/mm3 while in control group 20.91% neonates only had the same. This difference was statistically significant, (p<0.0001). Similarly, 70.91% neonates in case group had MPV more than >10.8 fl whereas in control group only 26.53% neonates had the same, with difference was statistically significant, (p<0.0001) Similarly, 65.81% neonates in case group and 34.69% in control group had PDW more than 19.1fl and this difference was statistically significant, (p=0.0001).Conclusions: High PDW, high MPV and low platelet count are more associated with neonatal sepsis. So, platelet and its indices may be used as a sensitive marker to identify septic babies and it may be combined with existing sepsis screen to specifically exclude non-septic case.

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Section: Introductionmentioning

confidence: 99%

Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Choudhary

Makwana

Mourya

et al. 2018

Int J Contemp Pediatr

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“…2 Few clinical scoring methods for the prediction of LNS have been developed, and they were mainly from the data of the neonates who had been worked-up as suspected sepsis. [3][4][5] The objectives of this study were to develop a practical, clinical prediction-scoring model for the diagnosis of LNS, and to validate the diagnostic performance of the model.…”

Section: Introductionmentioning

confidence: 99%

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

et al. 2005

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OBJECTIVE:Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this study. The objective was to develop and validate a simple prediction-scoring model for LNS defined as culture-proven sepsis occurring 72 hours after birth. METHODS:The study was performed at a university hospital in Bangkok. The derivation phase included medical records of 1870 neonates, randomly selected from 9347 records of neonates who had been hospitalized for >72 hours during 1998 to 2000, of which 1824 records were available. In all, 100 neonates were clinically suspected of sepsis and 17 had proven LNS. The validation phase included 73 neonates suspected of having sepsis during July 2002to June 2003 and 25 who had LNS. Weighted coefficients from Cox's proportional hazards model and receiveroperating-characteristic (ROC) curve analysis were used. RESULTS:The incidence density of LNS was 17/11355 (1.5/1000) person-days. A scoring model was developed and consisted of the following: hypotension (score 4), abnormal body temperature (score 3), respiratory insufficiency (score 2), neutrophil band form fraction >1% (score 2), platelet count <150 Â 10 3 /ml (score 2), and umbilical venous catheterization (1 to 7 or >7 days; score 2 or 4). The area under the ROC curves for prediction of LNS in a neonate suspected of sepsis in each of the two phases was 0.85 and 0.80, respectively (p ¼ 0.436). The mean probabilities of LNS were approximately 0.10 (low risk) for scores from 0 to 3; 0.50 (intermediate risk) for scores from 4 to 6; and 0.70 (high risk) for scores Z7. CONCLUSION:A simple prediction-scoring model for LNS was developed. Validation of the scores suggested good diagnostic performance.

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“…Figure 1 shows the results of the search strategy. The research period spanned from 1993 to 2007 with 3 western European, [27][28][29] 4 South Asian, [30][31][32][33] 1 Canadian, 34 and 1 Turkish study. 35 All researches were performed in level III settings of which one 33 was conducted in a low-resource level III hospital.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were internal 34 and external validation studies 28 of their former developed prediction score study. Another 2 studies 32,33 are adapted external validation studies of Singh et al 30 …”

Section: General Description Of the Included Studiesmentioning

confidence: 99%

Prediction Models for Neonatal Health Care–Associated Sepsis: A Meta-analysis

et al. 2015

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BACKGROUND AND OBJECTIVES: Blood culture is the gold standard to diagnose bloodstream infection but is usually time-consuming. Prediction models aim to facilitate early preliminary diagnosis and treatment. We systematically reviewed prediction models for health care-associated bloodstream infection (HABSI) in neonates, identified superior models, and pooled clinical predictors. Data sources: LibHub, PubMed, and Web of Science. METHODS:The studies included designed prediction models for laboratory-confirmed HABSI or sepsis. The target population was a consecutive series of neonates with suspicion of sepsis hospitalized for $48 hours. Clinical predictors had to be recorded at time of or before culturing. Methodologic quality of the studies was assessed. Data extracted included population characteristics, total suspected and laboratory-confirmed episodes and definition, clinical parameter definitions and odds ratios, and diagnostic accuracy parameters. RESULTS:The systematic search revealed 9 articles with 12 prediction models representing 1295 suspected and 434 laboratory-confirmed sepsis episodes. Models exhibit moderate-good methodologic quality, large pretest probability range, and insufficient diagnostic accuracy. Random effects meta-analysis showed that lethargy, pallor/mottling, total parenteral nutrition, lipid infusion, and postnatal corticosteroids were predictive for HABSI. Post hoc analysis with low-gestational-age neonates demonstrated that apnea/bradycardia, lethargy, pallor/mottling, and poor peripheral perfusion were predictive for HABSI. Limitations include clinical and statistical heterogeneity.CONCLUSIONS: Prediction models should be considered as guidance rather than an absolute indicator because they all have limited diagnostic accuracy. Lethargy and pallor and/or mottling for all neonates as well as apnea and/or bradycardia and poor peripheral perfusion for very low birth weight neonates are the most powerful clinical signs. However, the clinical context of the neonate should always be considered.

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Predictive Clinical Scores for Diagnosis of Late Onset Neonatal Septicemia

Cited by 48 publications

References 0 publications

Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

Prediction Models for Neonatal Health Care–Associated Sepsis: A Meta-analysis

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