Rapid diagnosis of neonatal bacteremia with acridine organe-stained buffy coat smears

Kleiman, Martin B.; Reynolds, Janet K.; Schreiner, Richard L.; Smith, James W.; Allen, Stephen D.

doi:10.1016/s0022-3476(84)80016-5

Cited by 23 publications

(13 citation statements)

References 7 publications

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“…15 Staining methods, including the use of acridine orange with buffy coat smears, can detect early-stage bacteremia before conventional blood cultures are positive. [8][9][10][16][17][18][19][20] Further, ISH, immunocytochemical methods, polymerase chain reaction (PCR), or cultures are more sensitive than blood cultures for detecting causative agents in the buffy coat fraction. 11,[21][22][23] These reports illustrate the importance of monitoring buffy coat fractions.…”

Section: Discussionmentioning

confidence: 99%

Clinical trial of in-situ hybridization method for the rapid diagnosis of sepsis

Shimada

Hayashi

Igarashi

et al. 1999

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

Clinical trial of in-situ hybridization method for the rapid diagnosis of sepsis

Shimada

Hayashi

Igarashi

et al. 1999

Journal of Infection and Chemotherapy

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“…1,2 Numerous investigators have evaluated the usefulness of various laboratory tests in the diagnosis of systemic infection in this population. [3][4][5][6] These include determination of C-reactive protein, 7 erythrocyte sedimentation rate, 8 haptoglobin, 9 orosomucoid, 10 fibronectin, 5 elastase-␣-1-proteinase inhibitor complex, 11 C3d, 12 endotoxin, 13 acridine orange cytospin, 14 and nitroblue tetrazolium reduction. 15 Although multiple tests have been used together for this purpose, perhaps the single test of greatest utility in establishing a diagnosis of sepsis has been the complete blood count (CBC) and in particular the various neutrophil parameters.…”

mentioning

confidence: 99%

Circulating Neutrophils in Septic Preterm Neonates: Comparison of Two Reference Ranges

Engle

Rosenfeld

Mouzinho³

et al. 1997

Pediatrics

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ABSTRACT. Objective. To study the effect of sepsis on circulating neutrophils in very low birth weight neonates and to assess the usefulness of recently revised reference ranges for circulating neutrophils in the diagnosis of sepsis in this population by comparison with previously reported reference ranges.Methods. Neutrophil parameters (absolute total neutrophils, absolute total immature neutrophils, and the immature:total neutrophil proportion) were analyzed retrospectively in 202 sepsis episodes in 192 neonates (birth weight ‫؍‬ 1055 ؎ 246 g, X ؎ SD; estimated gestational age ‫؍‬ 29 ؎ 2 weeks) between birth and 30 days of age. The percentage of values lying outside the reference ranges reported recently by Mouzinho et al 32 and previously by Manroe et al 24 were compared. To more accurately assess possible differences in specificity between the two reference ranges, neonates with early-onset group B streptococcal infection (n ‫؍‬ 19) were compared with a matched control group (n ‫؍‬ 51) using conditional logistic regression.Results. Greater sensitivity was observed using the previous reference ranges of Manroe et al 24 over the entire study period (0 to 720 hours) both for the initial and the second complete blood count (CBC). The previous reference ranges also were more sensitive than the revised ranges for the initial CBC at 0 to 72 and at 73 to 720 hours and for infections attributable to coagulase-negative staphylococci. However, specificity in neonates without group B streptococcal infection was significantly greater with the revised reference ranges compared with those of Manroe et al 24 (initial CBC, 73% vs 45%; serial CBCs, 59% vs 10%).Conclusion. The observed differences in sensitivities may be of limited clinical significance because very low birth weight infants often are begun on antibiotic therapy regardless of laboratory values. However, the striking differences in specificity using the revised reference ranges suggest that these ranges may be clinically useful in determining length of antimicrobial therapy in infants in whom cultures remain sterile. Pediatrics 1997;99(3). URL: http://www.pediatrics.org/cgi/content/full/99/3/e10; sepsis, very low birth weight neonate, neutrophils.

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“…13 " 15 Therefore, we sought to establish whether the AO stain would increase the yield of rapid microscopic examination of amniotic fluid.…”

Section: Discussionmentioning

confidence: 99%

“…Several investigators have suggested that the AO is superior to the Gram's stain in the detection of bacteria. 12 " 13 The purpose of this communication is to examine the diagnostic value of the AO stain in comparison to the Gram's stain for the rapid diagnosis of intra-amniotic infection.…”

mentioning

confidence: 99%

Diagnosis of Intra-Amniotic Infection: The Acridine Orange Stain

Romero¹,

Emamian²,

Quintero³

et al. 1989

Amer J Perinatol

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The rapid diagnosis of intra-amniotic infection in patients with premature rupture of the membranes (PROM) and preterm labor is of utmost importance. The Gram's stain examination of amniotic fluid can only detect half of these infections. The acridine orange (AO) stain has been claimed to be superior to the Gram's stain in the detection of bacteria in biologic fluids. Therefore, we undertook the present study to examine the value of AO in the detection of bacteria in amniotic fluid. One hundred and thirty-eight patients with a culture-documented prevalence of intra-amniotic infection of 23.2% were studied. The diagnostic indices of the AO were: sensitivity, 43.8%, specificity, 97.2%, positive predictive value, 82.8%, and negative predictive value, 85.1%; the diagnostic indices for the Gram's stain were: sensitivity, 46.8%, specificity, 98.1%, positive predictive value, 88.2%, and negative predictive value, 85.9%. There was no difference in the diagnostic values of the tests. The agreement between the two techniques was substantial, as indicated by a kappa index of 0.72 (SE = 0.17, p less than 0.001). The AO offered no significant advantage over the Gram's stain examination of amniotic fluid in the detection of intra-amniotic infection. However, the AO stain was able to identify mycoplasma infections that escaped detection by the Gram's stain. Therefore, the AO is presently the only microscopic technique capable of detecting mycoplasma in amniotic fluid.

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Rapid diagnosis of neonatal bacteremia with acridine organe-stained buffy coat smears

Cited by 23 publications

References 7 publications

Clinical trial of in-situ hybridization method for the rapid diagnosis of sepsis

Clinical trial of in-situ hybridization method for the rapid diagnosis of sepsis

Circulating Neutrophils in Septic Preterm Neonates: Comparison of Two Reference Ranges

Diagnosis of Intra-Amniotic Infection: The Acridine Orange Stain

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