Role of sepsis screen in the diagnosis of neonatal sepsis

Misra, Rabindra Nath; Jadhav, Savita; Ghosh, Purbasha; Gandham, Nageswari; Angadi, Kalpana; Vyawahare, Chanda

doi:10.4103/0975-2870.114649

Cited by 12 publications

(8 citation statements)

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“…The results in the present study were in accordance with Gerdes et al 37 Jadhav et al 15 and Bhale et al 31 The sensitivity of two or more abnormal parameters was 90.3%, specificity was 75.6%, positive predictive value was 77.0% and negative predictive value was 89.0% as shown in table 11. The sepsis screen should be considered as a positive septic screen, If two parameters are abnormal and antibiotic therapy can be started.…”

Section: • Total Leucocyte Count (Tlc) Of ≤5000/cummsupporting

confidence: 91%

“…But these are sophisticated and impractical for developing countries. [13][14][15] A good diagnostic test should have high sensitivity and specificity and should be cost effective with early availability of results. 13 Even though a positive blood culture is gold standard for diagnosis of neonatal sepsis the technique is time consuming, demands a proper laboratory setup and is positive in only 40% cases.…”

Section: Introductionmentioning

confidence: 99%

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Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

Lakhey

Shakya

2017

J Pathol Nep

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Background: Neonatal sepsis, a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life is a major cause of morbidity and mortality in newborn inborn. Early diagnosis is critical, as sepsis can progress more rapidly in neonates than in adults. An attempt was made to establish correlation between early neonatal sepsis screening & blood culture in neonates presenting with features of sepsis. The aim of this study is to assess the usefulness of sepsis screen in early diagnosis of neonatal septicemia. Materials and Methods:The study was done in Kist medical college and hospital, Nepal from October 2015 to October 2016. Statistical correlation between early indicators of sepsis screen & blood culture (considered as gold standard) was established in clinically suspicious cases of neonatal sepsis. Results: Out of 150 cases studied, 72 were culture positive. CRP (77.8%) and immature: total neutrophils ratio (73%) showed highest sensitivity. CRP (66.7%), I/T ratio (61.5%) and micro ESR (60.2%) showed highest specificity. Positive predictive value was highest for CRP (68.2%) followed by I/T ratio (63.8%) and corrected total leukocyte count (56.2%). Conclusion:Serum CRP is the most sensitive marker of sepsis. Use of peripheral smear study and CRP can be implicated effectively as a sepsis screen for early diagnosis of neonatal sepsis. The combination of parameters yielded better results than single tests and proved to be an invaluable tool for early diagnosis of neonatal sepsis.

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Section: • Total Leucocyte Count (Tlc) Of ≤5000/cummsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

Lakhey

Shakya

2017

J Pathol Nep

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“…Our study found a high sensitivity and NPV of the sepsis screen of 93.18% and 86% respectively whereas slightly lower specificity and PPV of 43.88% and 63.33% respectively. The sensitivity results in the present study were in accordance with Gerdes et al, Jadhav et al, and Bhale et al [19,22,24].…”

Section: Discussionsupporting

confidence: 93%

“…The table below compares the values among various studies. Some studies have reports very high sensitivities and negative predictive value up to 100% while some reported very high specificities and positive predive value upto 92 to 97 % [19][20][21][22][23][24]. Our study found a high sensitivity and NPV of the sepsis screen of 93.18% and 86% respectively whereas slightly lower specificity and PPV of 43.88% and 63.33% respectively.…”

Section: Discussionsupporting

confidence: 44%

A study of Neonatal Sepsis and to assess the validity of sepsis screen as a diagnostic tool

et al. 2018

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Introduction: Neonatal sepsis is the leading cause of neonatal mortality in the developing world. There is an increasing incidence of drug resistance among organisms. We have tried to the sepsis profile in our nursery and to assess the validity of sepsis screen as a diagnostic tool. We have also studied the individual parameters of the screen for their strength as a diagnostic tool. Methods: This was a prospective study carried out in the SCNU of MY Hospital and included 200 newborns with suspected sepsis. Sepsis Screen and Blood Cultures were done in all the babies and the results were analysed. Results: Out of the 200 patients with suspected sepsis, 150 (75%) had a positive sepsis screen whereas 102 (51%) were culture positive. Sepsis Screen was positive in 93.1% of total culture positive sepsis and in 56.1% of culture negative cases too. Thus, the Sensitivity and specificity for Septic Screen was calculated to be 93.18 and 43.88% repetitively. PPV was 63.33% and NPV was 86.0%. Conclusion: The bacteriological flora has changed over the last 12 years and there has been a high incidence of resistance to the first live antibiotics in our Nursery. The sepsis screen has a high negative predictive value and it is recommended that negative sepsis screen should warrant discontinuation of the empirical antibiotics to prevent the unnecessary use and the emergence of drug resistant organisms.

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“…The inflammatory cascade is triggered or augmented by the presence of microorganisms and by toxins. Some microorganisms produce exotoxin (staphylococci and streptococci), others endotoxin ( E. coli ), and others both exotoxin and endotoxin ( Pseudomonas ) [ 56 ]. The endotoxin is the most involved in the septic shock, mostly due to its biochemical structure (macromolecular complex glucose lipid protein included in the bacterial cell wall) [ 57 ].…”

Section: Circulating Mirnas As Biomarker For Sepsismentioning

confidence: 99%

Use of miRNAs as Biomarkers in Sepsis

Dumache

Rogobete

Bedreag

et al. 2015

Analytical Cellular Pathology

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Sepsis is one of the most common causes of death in critical patients. Severe generalized inflammation, infections, and severe physiological imbalances significantly decrease the survival rate with more than 50%. Moreover, monitoring, evaluation, and therapy management often become extremely difficult for the clinician in this type of patients. Current methods of diagnosing sepsis vary based especially on the determination of biochemical-humoral markers, such as cytokines, components of the complement, and proinflammatory and anti-inflammatory compounds. Recent studies highlight the use of new biomarkers for sepsis, namely, miRNAs. miRNAs belong to a class of small, noncoding RNAs with an approximate content of 19–23 nucleotides. Following biochemical and physiological imbalances, the expression of miRNAs in blood or other body fluids changes significantly. Moreover, its stability, specificity, and selectivity make miRNAs ideal candidates for sepsis biomarkers. In conclusion, we can affirm that stable species of circulating miRNAs represent potential biomarkers for monitoring the evolution of sepsis.

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Role of sepsis screen in the diagnosis of neonatal sepsis

Cited by 12 publications

References 0 publications

Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

A study of Neonatal Sepsis and to assess the validity of sepsis screen as a diagnostic tool

Use of miRNAs as Biomarkers in Sepsis

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