Diagnosis Of Sepsis In Newborns Research Articles

Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD.

Congenital heart diseases (CHD) are the most common causes of birth defects that have increased the risk of infections. Neonatal sepsis is a life-threatening condition and early diagnosis can be life-saving. We aimed to evaluate the potential role of the systemic immune-inflammatory index in the early diagnosis of neonatal sepsis. A retrospective cohort study was conducted on 166 newborns with a diagnosis of neonatal sepsis who were admitted to our hospital with CHD between January 2017 and June 2021. Haematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index were calculated for all patients at the time of diagnosis of neonatal sepsis (sepsis). The sepsis values of these indices were compared with the admission values (pre-sepsis) of the patients. The mean gestational age and birth weight of the patients were 38.36 ± 1.42 weeks and 3057.75 ± 484.68 g. It was found that absolute neutrophil count, systemic immune-inflammatory index, neutrophil/lymphocyte ratio, but not platelet/lymphocyte ratio were significantly increased at the time of sepsis. The receiver operating characteristic curve showed that systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count have predictive ability to define neonatal sepsis among newborns with CHD. The systemic immune-inflammatory index produced an area under the curve receiver operating characteristic curve of 0.76 (70% sensitivity, 70.5% specificity). To discriminate neonatal sepsis, the cut-off values of systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count were 517.19, 2.62, and 9210/mm3, respectively. As an easily accessible and reliable indicator, systemic immune-inflammatory index may be used in combination with the other parameters in the early diagnosis of neonatal sepsis.

Red cell distribution width as a prognostic marker in septic neonates versus healthy term newborns

Background: We evaluated the usefulness of RDW (red cell distribution width) as a diagnostic tool in newborn sepsis. Several biomarkers for sepsis have been studied including CRP (C-reactive protein), procalcitonin, interleukins, total WBC count (TC) absolute neutrophil count (ANC), ratio of immature neutrophils to total neutrophils (I/T ratio). An ideal biomarker for sepsis is still elusive. Hence we evaluated RDW as a sepsis marker as it was cheap and available. The objective of the study was to evaluate the role of RDW as a prognostic marker in newborn sepsis compared to healthy newborns.Methods: The study sample comprised of two groups (cases and control group) each with 40 neonates. Group 1 (cases group) comprised 40 newborns with suspected/probable sepsis based on clinical or laboratory parameters. In group 1 (suspected/probable sepsis) RDW was done at the time of suspicion of sepsis along with other relevant investigations. According to the clinical course these parameters were repeated 24-48 hrs after first value. Group 2 (control group) comprised 40 normal newborns in the postnatal ward. For the control group blood sampling for CBC and RDW was done simultaneously along with blood sampling for newborn screening.Results: On comparing the baseline variables there is no significant difference among cases and control group with respect to gender distribution, age in days, gestational age in weeks and birth weight. The mean RDW among the cases group was significantly higher than among the control group. In ROC analysis we obtained a cut off value of RDW of 17.25 is helpful to diagnose sepsis with reasonable sensitivity (70%) and specificity (60%).Conclusions: This study revealed that RDW may also be included in the diagnosis of sepsis in newborns as it is a simple, inexpensive, available and easily repeated test as it is routinely done with a complete blood count.

Malaria congénita por Plasmodium falciparum

La malaria congénita (MC) es la infección por Plasmodium spp adquirida in útero o durante el parto y sus manifestaciones clínicas son inespecíficas. Puede causar enfermedad grave en la embarazada y en el recién nacido.Objetivo: describir dos casos de MC causados por Plasmodium falciparum, diagnóstico diferencial de sepsis en recién nacidos de gestantes que hayan visitado o residan en áreas endémicas para malaria.Casos Clínicos: Neonatos de sexo femenino, nacidos en área no endémica para malaria, diagnosticados con sepsis neonatal y tratados con antibióticos sin respuesta clínica. Después de la primera semana de vida la gota gruesa identificó trofozoítos de Plasmodium falciparum y los neonatos recibieron tratamiento con quinina intravenosa con mejoría. Las madres de las recién nacidas tuvieron malaria en el embarazo, una de ellas recibió tratamiento y estaba asintomática y otra tenía malaria complicada al momento del parto.Conclusiones: La MC puede causar enfermedad neonatal grave con manifestaciones clínicas inespecíficas y similares a la sepsis, el tratamiento oportuno disminuye el riesgo de malaria complicada. Es un diagnóstico diferencial en recién nacidos de mujeres con malaria durante el embarazo o gestantes que visiten o residan en áreas endémicas.

Serum polymorphonuclear leukocyte elastase enzyme level in neonatal sepsis

Objective The aim of this study is to evaluate the clinical importance of polymorphonuclear leukocyte (PMN) elastase level in neonatal sepsis. Background Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life. When pathogenic bacteria gain access into the bloodstream, they may cause overwhelming infection without much localization (septicemia) or may be predominantly localized to the lung (pneumonia) or the meninges. Patients and methods This prospective study was performed on 60 newborns, which included 30 newborns with positive clinical sepsis score and 30 healthy neonates matched for age, sex, and weight as a control group. Blood samples for blood culture, routine biochemistry, whole blood count, immature neutrophil: total neutrophil ratio, C-reactive protein, and PMN elastase were taken. Antibiotics were commenced after the blood specimens were collected. Second blood samples for sepsis markers were obtained from the patient only on the fourth day of treatment. Results In our study, we found that respiratory distress was the most common clinical presentation (86.7%) in neonates with sepsis followed by poor activity (83.3%) and jaundice (40%). PMN elastase levels in neonates with sepsis were highly significantly increased compared with controls. Overall, 100% of patients had a positive PMN elastase test result, and PMN elastase has a sensitivity of 96% and positive predictive value of 86% in prediction of sepsis. The sensitivity of C-reactive protein in detecting sepsis was 77%, specificity was 93%, positive predictive value was 87%, and negative predictive value was 14%. Conclusion These findings indicate that PMN elastase level is a major indicator for the early diagnosis of sepsis in newborns.

What are the cut‐off levels for IL‐6 and CRP in neonatal sepsis?

Neonatal sepsis, characterized by systemic signs of infection in the first month of life, remains an important clinical syndrome. Despite advances in neonatology, it has high rates of mortality and morbidity. The combine or alone usage of interleukin-6 (IL-6) and C-reactive protein (CRP) has recently been proven to be useful in the early diagnosis of sepsis in newborns. The study included 282 patients; there were 232 in Group I (170 proven and 62 clinical sepsis) and 50 in Group II (control group). The optimum cut-off value in the diagnosis of neonatal sepsis was found to be 24.65 pg/ml for IL-6 and 4.82 mg/l for CRP. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this IL-6 cut-off for neonatal sepsis were 72, 84, 95, and 42%, respectively. Sensitivity, specificity, PPV, and NPV of the CRP cut-off for neonatal sepsis were 67, 97, 99, and 39%, respectively. The combination of IL-6 (>24.65 pg/ml) and CRP (>4.82 mg/l) in the diagnosis of neonatal sepsis gave sensitivity, specificity, PPV, and NPV of 53, 100, 100, and 33%, respectively. To our knowledge, this is the largest reported study seeking to determine cut-off levels for IL-6 and CRP in the diagnosis of neonatal sepsis. In conclusion, we think that it is useful to evaluate IL-6 and CRP, in combination, for the early diagnosis of neonatal sepsis.

A Potential Aid in Diagnosis of Sepsis in Newborns

The clinical diagnosis of early-onset sepsis (EOS) in newborns is difficult because of the nonspecific signs and the low diagnostic sensitivity of

In Neonates, One Culture Is Enough

The gold standard for the diagnosis of sepsis in newborns is the isolation of a microorganism from blood. There has been some debate about the optimal