Predictive value of SNAP and SNAP-PE for neonatal mortality

Silveira, Rita de Cássia dos Santos; Schlabendorff, Mariani; Procianoy, Renato Soibelmann

doi:10.2223/jped.343

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…Detection of bacterial DNA in blood samples of neonates is suggested to represent a rapid and sensitive supplement to blood culture in diagnosing bacterial sepsis in neonates [ 5 , 14 , 16 ]. However, at present there are no standardised clinically evaluated methods available for detection of bacterial DNA in blood samples from neonates.…”

Section: Introductionmentioning

confidence: 99%

Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study

et al. 2009

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Background: Early onset bacterial sepsis is a feared complication of the newborn. A large proportion of infants admitted to the Neonatal Intensive Care Unit (NICU) for suspected sepsis receive treatment with potent systemic antibiotics while a diagnostic workup is in progress. The gold standard for detecting bacterial sepsis is blood culture. However, as pathogens in blood cultures are only detected in approximately 25% of patients, the sensitivity of blood culture is suspected to be low. Therefore, the diagnosis of sepsis is often based on the development of clinical signs, in combination with laboratory tests such as a rise in C -reactive protein (CRP). Molecular assays for the detection of bacterial DNA in the blood represent possible new diagnostic tools for early identification of a bacterial cause.Methods: A broad range 16S rDNA polymerase chain reaction (PCR) without preincubation was compared to conventional diagnostic work up for clinical sepsis, including BACTEC blood culture, for early determination of bacterial sepsis in the newborn. In addition, the relationship between known risk factors, clinical signs, and laboratory parameters considered in clinical sepsis in the newborn were explored.Results: Forty-eight infants with suspected sepsis were included in this study. Thirty-one patients were diagnosed with sepsis, only 6 of these had a positive blood culture. 16S rDNA PCR analysis of blinded blood samples from the 48 infants revealed 10 samples positive for the presence of bacterial DNA. PCR failed to be positive in 2 samples from blood culture positive infants, and was positive in 1 sample where a diagnosis of a non-septic condition was established. Compared to blood culture the diagnosis of bacterial proven sepsis by PCR revealed a 66.7% sensitivity, 87.5% specificity, 95.4% positive and 75% negative predictive value. PCR combined with blood culture revealed bacteria in 35.1% of the patients diagnosed with sepsis. Irritability and feeding difficulties were the clinical signs most often observed in sepsis. CRP increased in the presence of bacterial infection. Conclusion:There is a need for PCR as a method to quickly point out the infants with sepsis. However, uncertainty about a bacterial cause of sepsis was not reduced by the PCR result, reflecting that methodological improvements are required in order for DNA detection to replace or supplement traditional blood culture in diagnosis of bacterial sepsis.

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Section: Introductionmentioning

confidence: 99%

Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study

et al. 2009

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“…In the previous studies, cut-offs of 33, 24 and 32 were determined on ROC analysis. [13][14][15] In the present study, evaluation of all centers using a single cut-off resulted in statistically significant differences in specificity and sensitivity. The overall mortality rate was 11.3%, but mortality rate variability between the NICU may be explained by differences in patients and resources.…”

Section: Discussionmentioning

confidence: 48%

“…Cut‐offs vary with institution. In the previous studies, cut‐offs of 33, 24 and 32 were determined on ROC analysis . In the present study, evaluation of all centers using a single cut‐off resulted in statistically significant differences in specificity and sensitivity.…”

Section: Discussionmentioning

confidence: 59%

Evaluation of Score for Neonatal Acute Physiology and Perinatal Extension II and Clinical Risk Index for Babies with additional parameters

Asker

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Yapıcıoğlu

et al. 2016

Pediatrics International

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“…The increased survival of very low birth weight (VLBW) infants due to recent advances in neonatal care has produced a new population of infants at very high risk of developing comorbidity 4 . Previous articles have evaluated the usefulness of the neonatal illness severity scores like CRIB, SNAP, SNAPPE and cumulative SNAP, to predict mortality and morbidities including ROP and BPD 15,16 . In our study, high SNAPPE-II values showed better discrimination as predictors of neonatal morbidities and as a common independent risk factor for ROP and BPD.…”

Section: Discussionmentioning

confidence: 99%

SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants

Özcan¹,

Kavurt²,

Aydemir³

et al. 2017

Turk J Pediatr

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Illness severity scores were described to estimate the mortality and morbidity risks based on data obtained shortly after admission to an intensive care unit. The aim of this study is to evaluate Scores for Neonatal Acute PhysiologyPerinatal Extension-II (SNAPPE-II) as a predictors of neonatal morbidities such as bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP). A retrospective cohort study was conducted between October 2011-2012. A total of 278 preterm infants born with gestational age (GA) < 32 weeks and birthweight (BW) <1,500 g were given SNAPPE-II scores based on data collected within the first 12 h of admission to ICU. The main outcomes were the development of BPD and ROP. The main variable was the SNAPPE-II obtained at admission. Logistic regression and receiver-operating characteristics (ROC) curve were calculated for SNAPPE-II. The mean GA and mean BW of the whole cohort were 29.2 weeks (± 2.15) and 1,323 g (±331,4), respectively. The median SNAPPE-II value was significantly higher among patients with BPD and ROP. After logistic regression the SNAPPE-II was independent risk factor for BPD and ROP. The best discriminative cutoff value for BPD was 14.5 (sensitivity 92%) and for ROP was 23.5 (sensitivity 80%). The present study reviewed an association between SNAPPE-II and neonatal morbidities including ROP and BPD.

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Predictive value of SNAP and SNAP-PE for neonatal mortality

Cited by 14 publications

References 16 publications

Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study

Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study

Evaluation of Score for Neonatal Acute Physiology and Perinatal Extension II and Clinical Risk Index for Babies with additional parameters

SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants

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