Abstract
Neonatal sepsis remains a significant diagnostic challenge in newborn care. It has the potential to be disastrous, but precise diagnosis is difficult. No biomarker has yet demonstrated sufficient diagnostic accuracy to rule out sepsis when clinical suspicion exists. As a result, neonates with suspected sepsis are treated with empiric antibiotics. These unnecessary antibiotics promote bacterial antibiotic resistance, raise economic costs, and alter the composition of the gut microbiota. This study aimed to determine the diagnostic accuracy of procalcitonin in the prompt diagnosis of neonatal sepsis.Articles were systematically screened in PubMed/MEDLINE, PubMed Central (PMC), and ScienceDirect, using keywords and Medical Subject Heading (MeSH) terms to identify the relevant articles. Additionally, one article from the Indian Journal of Applied Research was also used. Inclusion/exclusion criteria were applied post article screening via title and abstracts. Quality appraisal check was done using the Scale for the Assessment of Narrative Review Articles (SANRA) checklist, A Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist, and Newcastle-Ottawa checklist. Six related articles were strictly reviewed.Procalcitonin is a useful biomarker in the early diagnosis of neonatal sepsis. Because procalcitonin has a better correlation with proven sepsis and is an early biomarker in diagnosing neonatal sepsis, it should be included in the overall sepsis evaluation. Future clinical trials on optimal cut-off levels of procalcitonin with shifting neonatal ages and its use in the post-op setting are needed.
Highlights
BackgroundNewborn sepsis (NS) is a major cause of neonatal morbidity and mortality, and it has become a serious global public health issue [1,2]
The Medical Subject Heading (MeSH) strategy used in PubMed was: Procalcitonin OR proinflammatory marker OR ("Procalcitonin"[Mesh]) AND ("Procalcitonin/blood"[Mesh] OR "Procalcitonin/immunology" [Mesh]) AND C-Reactive Protein OR ("C-Reactive Protein/blood"[Mesh] OR "C-Reactive Protein/immunology"[Mesh] OR "C-Reactive Protein/therapeutic use"[Mesh]) AND Neonatal Sepsis OR Neonatal septic shock OR Neonatal pyemia OR Neonatal septic infection OR Neonatal septicemia OR Neonatal toxemia OR Neonatal inflammation OR ("Neonatal Sepsis/blood"[Majr] OR "Neonatal Sepsis/diagnosis"[Majr] OR "Neonatal Sepsis/mortality"[Majr] OR "Neonatal Sepsis/prevention and control" [Majr])
Out of 1464 articles, 1399 articles were from PubMed, 64 studies from ScienceDirect, and one article was obtained via reference perusal; 1200 articles remained after removing 264 duplicate articles
Summary
BackgroundNewborn sepsis (NS) is a major cause of neonatal morbidity and mortality, and it has become a serious global public health issue [1,2]. Microbial cultures can aid in diagnosing serious bacterial infections. They frequently produce false-negative results, after maternal antibiotic usage, and may produce false-positive results due to sample contamination. Newborns with clinical signs of sepsis or risk factors for serious bacterial infections are typically treated with antibiotics while microbiology testing results are awaited [5]. This eventually leads to antibiotic overuse, resulting in the growth of numerous drug-resistant bacteria in the neonatal intensive care unit (NICU) [6,7]. Its specificity is limited, and it is best used in conjunction with another serum biomarker
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