Values of C‐reactive protein, procalcitonin, and Staphylococcus‐specific PCR in neonatal late‐onset sepsis

Makhoul, Imad R.; Yacoub, A; Smolkin, Tatiana; Sujov, Polo; Kassis, Imad; Sprecher, Hannah

doi:10.1080/08035250600554250

Cited by 33 publications

(19 citation statements)

References 29 publications

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“…Despite the development of rapid quantitative bedside assays for CRP requiring an insignificant amount of blood, the short report by Makhoul and coworkers on late-onset sepsis is the only one published about their use in the neonatal period (11). Some authors studied the usefulness of CRP determinations in neonatal sepsis, but they did not use bedside tests (4,8,17,18). Others studied bedside tests in pediatric patients, but not in neonates (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Reliability of two different bedside assays for C-reactive protein in newborn infants

Zecca

Barone

Corsello

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Bedside tests for C-reactive protein (CRP) have been studied in pediatric patients, but not in neonates. Methods:This study compared the results of two rapid bedside tests for CRP (Quick-Read CRP, Orion Diagnostic, Espoo, Finland and NycoCard CRP-Single Test, Axis-Shield, Oslo, Norway) with those of our central laboratory method (CRP-Lab) in newborn infants. CRP concentrations were determined using 72 samples obtained from 43 infants with suspected sepsis occurring between 1 and 28 days of life. Results: Considering positive CRP concentrations to be G10 mg/L, both bedside tests had good specificity (Quick-Read 80.5%, NycoCard 83.3%) and sensitivity (Quick-Read 97.2%, NycoCard 94.4%) when compared with our CRP-Lab. The agreement of measurement with central laboratory values was high for both the bedside tests, without statistically significant differences between the methods. The Quick-Read and NycoCard methods did not show any statistically significant systematic proportional bias when compared with the central laboratory values. The accuracy of the results of both bedside tests is somewhat decreased when CRP concentrations are )100 mg/L. Conclusions: This study shows that both the QuickRead and the NycoCard test can be used for serial determinations of CRP concentrations in newborn infants. They require small volumes of blood and provide reliable results in -5 min.

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Section: Discussionmentioning

confidence: 99%

Reliability of two different bedside assays for C-reactive protein in newborn infants

Zecca

Barone

Corsello

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…This group reported sensitivity and specificity of 98 and 100%, respectively, for S. aureus ( nuc gene) and sensitivity and specificity of 97 and 100%, respectively, for MRSA ( mecA gene) [47]. Makhoul et al studied Staphylococcus -specific PCR in the diagnosis of both early- and late-onset neonatal sepsis [48–50]. In a study of 215 clinical samples of late-onset neonatal sepsis, including 13 cases of staphylococcal bacteremia, sensitivity, specificity, PPV and NPV were 69.2, 100, 100 and 98%, respectively [48].…”

Section: Pathogen-specific Pcr Assaysmentioning

confidence: 99%

“…In a study of 215 clinical samples of late-onset neonatal sepsis, including 13 cases of staphylococcal bacteremia, sensitivity, specificity, PPV and NPV were 69.2, 100, 100 and 98%, respectively [48]. In a subsequent report that evaluated 148 clinical samples in 111 neonates with sepsis after 3 days of age, Staphylococcus -specific PCR showed a sensitivity, specificity, PPV and NPV of 57.1, 94.7, 53.3 and 95.4%, respectively, compared with Staphylococcus -positive blood cultures [50]. However, Staphylococcus -specific PCR may not be useful in early-onset sepsis due to the paucity of staphylococcal infections [49].…”

Section: Pathogen-specific Pcr Assaysmentioning

confidence: 99%

Molecular microbiological methods in the diagnosis of neonatal sepsis

Venkatesh

Flores

Luna

et al. 2010

Expert Review of Anti-infective Therapy

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Neonatal sepsis is a major cause of neonatal mortality and morbidity. The current gold standard for diagnosis of sepsis, namely blood culture, suffers from low sensitivity and a reporting delay of approximately 48-72 h. Rapid detection of sepsis and institution of antimicrobial therapy may improve patient outcomes. Rapid and sensitive tests that can inform clinicians regarding the institution or optimization of antimicrobial therapy are urgently needed. The ideal diagnostic test should have adequate specificity and negative predictive value to reliably exclude sepsis and avoid unnecessary antibiotic therapy. We comprehensively searched for neonatal studies that evaluated molecular methods for diagnosis of sepsis. We identified 19 studies that were assessed with respect to assay methodology and diagnostic characteristics. In addition, we also reviewed newer molecular microbiological assays of relevance that have not been fully evaluated in neonates. Molecular methods offer distinct advantages over blood cultures, including increased sensitivity and rapid diagnosis. However, diagnostic accuracy and cost-effectiveness should be established before implementation in clinical practice. Keywords diagnosis; FISH; microarray; molecular; neonate; PCR; sepsis Neonatal sepsis is a frequent life-threatening problem in neonatal intensive care units, particularly in very-low-birthweight infants (VLBW; infants with birthweight <1500 g) [1][2][3]. Early-onset sepsis (EOS; sepsis in infants <72 h old) occurs in 1.5-1.9% of VLBW infants, and late-onset sepsis (LOS; onset after 72 h of life) in approximately 20% [1]. Coagulasenegative staphylococci (CONS), Staphylococcus aureus and fungi are responsible for most neonatal infections [1]. Neonatal mortality in LOS is approximately 18% overall and 36% in Gram-negative sepsis. Sepsis also increases neonatal morbidities including patent ductus arteriosus, need for intravascular access, need for parenteral nutrition, bronchopulmonary † Author for correspondence: Tel.: +1 832 824 3206, Fax: +1 832 825 3204, mohanv@bcm.edu.For reprint orders, please contact reprints@expert-reviews.com Financial & competing interests disclosureFunding for color printing of the figures was provided by AdvanDx (MA, USA). Mohan Pammi Venkatesh is funded by CHRCDA grant (NIH K12 HD41648). James Versalovic is supported by R01 AT004326-01A1 NIH/NCCAM, R01 DK065075-01 NIH/NIDDK and 1UH2HG083990-01 NIH/NHGRI. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript. NIH Public Access Author ManuscriptExpert Rev Anti Infect Ther. Author manuscript; available in PMC 2011 July 1. . In a large cohort of 6093 extremely low birthweight infants (ELBW; birthweight ≤1000 g), infected infants had a significantly higher incidence of adverse developmental outc...

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“…Blood culture remains the diagnostic gold standard for late-onset sepsis. However, clinicians frequently rely on screening tests, such as the white blood cell count, immature-to-total neutrophil ratio, C-reactive protein, and other biomarkers, to guide decisions regarding initiation or discontinuation of antimicrobial therapy [6,12,17,21] .…”

Section: Introductionmentioning

confidence: 99%

Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants

Leante-Castellanos

Lloreda-García

García-González

et al. 2012

Journal of Perinatal Medicine

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Values of C‐reactive protein, procalcitonin, and Staphylococcus‐specific PCR in neonatal late‐onset sepsis

Abstract: Hypotension, mechanical ventilation, I/T > 0.2, CRP > 1.0 mg/dl, and SGA status at onset of sepsis are significant predictors of proven neonatal LOS. Staphylococcus-specific PCR might be of value in ruling out staphylococcal sepsis.

Cited by 33 publications

References 29 publications

Reliability of two different bedside assays for C-reactive protein in newborn infants

Reliability of two different bedside assays for C-reactive protein in newborn infants

Molecular microbiological methods in the diagnosis of neonatal sepsis

Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants

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