Predictive Scores for Late-Onset Neonatal Sepsis as an Early Diagnostic and Antimicrobial Stewardship Tool: What Have We Done So Far?

Sofouli, Georgia Anna; Kanellopoulou, Afroditi; Vervenioti, Aggeliki; Dimitriou, Gabriel; Gkentzi, Despoina

doi:10.3390/antibiotics11070928

Cited by 11 publications

(7 citation statements)

References 49 publications

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“…However, laboratory assessment is time- consuming and requires respective equipment. Therefore, the incorporation of clinical and readily available laboratory variables in a scoring model may be optimal ( 67 ).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

et al. 2022

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BackgroundWe aimed to develop and validate a diagnostic model for sepsis among neonates evaluated for suspected sepsis, by incorporating thromboelastometry parameters, maternal/neonatal risk factors, clinical signs/symptoms and laboratory results.MethodsThis retrospective cohort study included 291 neonates with presumed sepsis, hospitalized in a NICU, from 07/2014 to 07/2021. Laboratory tests were obtained on disease onset and prior to initiating antibiotic therapy. Τhromboelastometry extrinsically activated (EXTEM) assay was performed simultaneously and Tοllner and nSOFA scores were calculated. Sepsis diagnosis was the outcome variable. A 10-fold cross-validation least absolute shrinkage and selection operator logit regression procedure was applied to derive the final multivariable score. Clinical utility was evaluated by decision curve analysis.ResultsGestational age, CRP, considerable skin discoloration, liver enlargement, neutrophil left shift, and EXTEM A10, were identified as the strongest predictors and included in the Neonatal Sepsis Diagnostic (NeoSeD) model. NeoSeD score demonstrated excellent discrimination capacity for sepsis and septic shock with an AUC: 0.918 (95% CI, 0.884–0.952) and 0.974 (95% CI, 0.958–0.989) respectively, which was significantly higher compared to Töllner and nSOFA scores.ConclusionsThe NeoSeD score is simple, accurate, practical, and may contribute to a timely diagnosis of sepsis in neonates with suspected sepsis. External validation in multinational cohorts is necessary before clinical application.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

et al. 2022

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“…The variety of the studies depicts the interest and the need for an easy-to-use and accurate scoring model. Some of these scores consisted exclusively of clinical variables [ 20 , 21 , 22 , 23 ], or only of laboratory variables [ 24 , 25 , 26 ], while others only used risk factors [ 27 ] and other combinations of these types of parameters [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Some of these studies analysed the changes of signs over time, as we also did in our study.…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis of Late-Onset Neonatal Sepsis Using a Sepsis Prediction Score

et al. 2023

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Sepsis represents a common cause of morbidity in the Neonatal Intensive Care Unit (NICU). Our objective was to assess the value of clinical and laboratory parameters in predicting septicemia (positive blood culture) in NICU infants. In the first part of the present study (derivation cohort) we retrospectively reviewed the clinical files of 120 neonates with symptoms of suspected sepsis and identified clinical and laboratory parameters associated with proven sepsis on the day the blood culture was taken, as well as 24 h and 48 h earlier. These parameters were combined into a sepsis prediction score (SPS). Subsequently (validation study), we prospectively validated the performance of the SPS in a cohort of 145 neonates. The identified parameters were: temperature instability, platelet count < 150,000/mm3, feeding volume decrease > 20%, changes in blood glucose > 50%, CRP > 1 mg/dL, circulatory and respiratory deterioration. In the retrospective cohort, on the day the blood culture was obtained, a SPS ≥ 3 could predict sepsis with 82.54% sensitivity, 85.96% specificity, 5.88 PLR (Positive Likelihood Ratio), 0.20 NLR (Negative Likelihood Ratio), 86.67% PPV (Positive Predictive Value), 81.67% NPV (Negative Predictive Value) and 84.17% accuracy. In the prospective cohort, on the day the blood culture was obtained, a SPS ≥ 3 could predict sepsis with 76.60% sensitivity, 72.55% specificity, 2.79 PLR, 0.32 NLR, 83.72% PPV, 62.71% NPV and 75.17% accuracy. We concluded that this combination of clinical and laboratory parameters may assist in the prediction of septicemia in NICUs.

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“…Some individuals may have residual viral DNA or RNA in their CSF from a previous, resolved infection, leading to false‐positive results 26 . Furthermore, the sensitivity of CSF analysis can vary depending on the timing of the test in relation to symptom onset, making early diagnosis challenging 27 …”

Section: Current Diagnostic Strategies For Neurotropic Virusesmentioning

confidence: 99%

Utilising biosensor‐based approaches for identifying neurotropic viruses

Alissa,

Hjazi

2024

Reviews in Medical Virology

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Neurotropic viruses, with their ability to invade the central nervous system, present a significant public health challenge, causing a spectrum of neurological diseases. Clinical manifestations of neurotropic viral infections vary widely, from mild to life‐threatening conditions, such as HSV‐induced encephalitis or poliovirus‐induced poliomyelitis. Traditional diagnostic methods, including polymerase chain reaction, serological assays, and imaging techniques, though valuable, have limitations. To address these challenges, biosensor‐based methods have emerged as a promising approach. These methods offer advantages such as rapid results, high sensitivity, specificity, and potential for point‐of‐care applications. By targeting specific biomarkers or genetic material, biosensors utilise technologies like surface plasmon resonance and microarrays, providing a direct and efficient means of diagnosing neurotropic infections. This review explores the evolving landscape of biosensor‐based methods, highlighting their potential to enhance the diagnostic toolkit for neurotropic viruses.

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Predictive Scores for Late-Onset Neonatal Sepsis as an Early Diagnostic and Antimicrobial Stewardship Tool: What Have We Done So Far?

Cited by 11 publications

References 49 publications

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

Early Diagnosis of Late-Onset Neonatal Sepsis Using a Sepsis Prediction Score

Utilising biosensor‐based approaches for identifying neurotropic viruses

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