scholarly journals Endocan - a potential diagnostic marker for early onset sepsis in neonates

2019 ◽  
Vol 13 (04) ◽  
pp. 311-317 ◽  
Author(s):  
Gabriela Ildiko Zonda ◽  
Radu Zonda ◽  
Andrei Tudor Cernomaz ◽  
Luminita Paduraru ◽  
Andreea Luciana Avasiloaiei ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Clinical Signs ◽  
Serum Levels ◽  
Clinical Suspicion ◽  
Low Concentrations ◽  
Early Onset Sepsis ◽  
Pregnancy And Delivery ◽  
History Of

Introduction: Neonatal early onset sepsis assessment is based on the history of pregnancy and delivery and nonspecific clinical signs. None of the biomarkers currently in use for clinical practice has adequate prognostic value, so it is not possible to clearly distinguish neonates with culture-proven sepsis from those with only risk factors or clinical suspicion. Endocan is an endothelial mediator involved in the inflammatory response that is present in low concentrations in the serum of healthy subjects, and in much higher concentrations in patients with SIRS and septic shock. The purpose of this study is to evaluate the utility of serum endocan serum levels as a biomarker for the diagnosis of neonatal early onset sepsis (EOS). Methodology: Serum endocan concentration was measured in newborns with clinical suspicion of EOS admitted to the Neonatal Intensive Care Unit on day 1, 3 and 7. Results: Serum endocan levels were significantly increased in septic compared to non-septic neonates in the early stages of sepsis (2.43 ± 0.95 vs. 1.77 ± 0.57, p = 0.004), continued to rise up to 72 hours from onset and then decreased by the seventh day under treatment. Conclusions: These results suggest a potential role for endocan as an early marker for diagnosis and follow-up in neonatal EOS. Studies on a larger number of cases are needed in order to establish the practical utility of this molecule as a diagnostic tool for clinical practice.

scholarly journals EVALUATION OF POSITIVITY OF CRP TEST IN EARLY ONSET NEONATAL SEPSIS IN RELATION TO DURATION OF PROM VS PROM DELIVERY INTERVAL (PDI)

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Samiksha Sharma ◽  
Girijanand Jha ◽  
Binod Kr Singh ◽  
Saroj Kumar
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Acute Inflammation ◽  
Antenatal Clinic ◽  
Medical College ◽  
Reactive Protein ◽  
Membrane Rupture ◽  
Early Onset Sepsis ◽  
History Of

Early onset infections are caused by organism prevalent in the maternal genital tract or in the delivery area. PROM is rupture of membranes before the onset of labour after 37 completed weeks of gestation. Intra amniotic infection is an acute inflammation of the membrane and chorion of the placenta, typically due to ascending polymicrobial bacterial infection in the setting of membrane rupture. Hence based on above conditions the present study was planned for Evaluation of Positivity of CRP test in early Onset Neonatal Sepsis in Relation to Duration of PROM vs PROM Delivery Interval (PDI). The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from November 2018 to June 2019. In the present study 50 mothers attended t antenatal clinic towards term pregnancy with history of leaking or confirmed PROM were enrolled. Clinical PROM was confirmed by speculum examination and the duration was recorded. All cases managed actively and the interval between PROM and delivery were recorded in obstetric unit of this hospital. The data generated from the present study concludes that even if 6 hour PROM is high risk for EONS, PDI should be considered first before PROM. So that, we will be more cautious and supportive and use of antibiotics in treatment to prevent need for neonatal intensive care without increase in perinatal morbidity and mortality. Keywords: Early onset Sepsis (EOS), C- Reactive Protein (CRP), Premature rupture of membrane( PROM) PROM delivery interval(PDI), etc.

Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

2018 ◽  
Vol 36 (12) ◽  
pp. 1295-1303
Author(s):  
Pakaphan Kiatchoosakun ◽  
Junya Jirapradittha ◽  
Prapassara Sirikarn ◽  
Malinee Laopaiboon ◽  
Porjai Pattanittum ◽  
...  
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Antibiotic Use ◽  
Adverse Outcomes ◽  
High Rate ◽  
Northeast Thailand ◽  
Suspected Sepsis ◽  
Early Onset Sepsis

Objective Antibiotics are commonly prescribed in neonatal intensive care units (NICUs) for suspected sepsis because of the nonspecific clinical symptoms of sepsis. The overuse of antibiotic is associated with adverse outcomes. This study aimed to determine the rate of early-onset sepsis (EOS) and antibiotic use in neonates admitted to three NICUs in Northeast Thailand Study Design This is a descriptive study using the data collected in the South East Asia—Using Research for Change in Hospital-acquired Infection in Neonates project. Neonates admitted within 3 days of life were included. EOS was defined as neonates who presented with three or more clinical signs or laboratory results suggested sepsis and received antibiotics for at least 5 days. Those with positive blood culture were culture-proven EOS. Antibiotic use within 3 days of life and up to 28 days was described. Results Among 1,897 neonates, 160 cases were classified as EOS (8.4%) with culture-proven EOS in 4 cases (0.2%). The median durations of antibiotic use in culture-proven and culture-negative EOSs were 15 and 8 days, respectively. Conclusion The rate of culture-proven EOS was low, but there was a high rate of antibiotic use. Antibiotic stewardship should be emphasized.

scholarly journals Relevance of Biomarkers Currently in Use or Research for Practical Diagnosis Approach of Neonatal Early-Onset Sepsis

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 309
Author(s):  
Maura-Adelina Hincu ◽  
Gabriela-Ildiko Zonda ◽  
Gabriela Dumitrita Stanciu ◽  
Dragos Nemescu ◽  
Luminita Paduraru
Keyword(s):  
High Mortality ◽  
Early Onset ◽  
Clinical Signs ◽  
Developed Countries ◽  
Extremely Low Birth Weight ◽  
Invasive Infection ◽  
Acute Phase Reactants ◽  
Hematological Indices ◽  
Live Births ◽  
Early Onset Sepsis

Neonatal early-onset sepsis (EOS) is defined as an invasive infection that occurs in the first 72 h of life. The incidence of EOS varies from 0.5–2% live births in developed countries, up to 9.8% live births in low resource settings, generating a high mortality rate, especially in extremely low birth weight neonates. Clinical signs are nonspecific, leading to a late diagnosis and high mortality. Currently, there are several markers used for sepsis evaluation, such as hematological indices, acute phase reactants, cytokines, which by themselves do not show acceptable sensitivity and specificity for the diagnosis of EOS in neonates. Newer and more selective markers have surfaced recently, such as presepsin and endocan, but they are currently only in the experimental research stages. This comprehensive review article is based on the role of biomarkers currently in use or in the research phase from a basic, translational, and clinical viewpoint that helps us to improve the quality of neonatal early-onset sepsis diagnosis and management.

Implementation and Evaluation of the Early-Onset Sepsis Risk Calculator in a High-Risk University Nursery

2017 ◽  
Vol 57 (9) ◽  
pp. 1080-1085 ◽  
Author(s):  
Jessica B. Beavers ◽  
Shasha Bai ◽  
Jennifer Perry ◽  
Jordan Simpson ◽  
Sara Peeples
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Risk Calculator ◽  
Admission Rates ◽  
Early Onset Sepsis ◽  
Sepsis Risk ◽  
Control And Prevention ◽  
Nicu Admission

There is growing interest in the Kaiser early-onset sepsis (EOS) risk calculator though institutions are hesitant to deviate from the Centers for Disease Control and Prevention guidelines and implement this in their hospitals. We describe the process of implementing routine use of the risk calculator in term and late preterm newborns delivered to mothers with chorioamnionitis in a level III neonatal intensive care unit (NICU). A retrospective chart review of infants delivered to mothers with chorioamnionitis from 2011 to 2014 was performed. Implementation of routine use of the calculator began in January 2015; preintervention and postintervention data were analyzed after a 9-month period of routine use. Following implementation, NICU admission rates, number of blood cultures drawn, and rates of antibiotic use dropped by 54%, 42%, and 59%, respectively ( P < .001). No negative outcomes were reported. In this article, we describe how the calculator was safely implemented in our NICU while decreasing the number of interventions.

scholarly journals Early-Onset Sepsis Risk Calculator: A Review Of Its Effectiveness And Comparative Study With Our Evidence-Based Local Guidelines

2021 ◽  
Author(s):  
Gianluigi Laccetta ◽  
Massimiliano Ciantelli ◽  
Cristina Tuoni ◽  
Emilio Sigali ◽  
Mario Miccoli ◽  
...  
Keyword(s):  
Gestational Age ◽  
Early Onset ◽  
Clinical Signs ◽  
Risk Calculator ◽  
Live Births ◽  
Early Onset Sepsis ◽  
Number Of Patients ◽  
Sepsis Risk ◽  
Empirical Antibiotics ◽  
Sepsis Calculator

Abstract Background According to most early-onset sepsis management guidelines, approximately 10% of the total neonatal population are exposed to antibiotics in the first postnatal days with subsequent increase of neonatal and pediatric comorbidities. Early-onset sepsis risk calculator has been developed with the purpose of avoiding antibiotic overtreatment among neonates ≥ 34 weeks’ gestational age: a review of literature demonstrates its effectiveness in reducing antibiotic overtreatment, laboratory testing, painful procedures and NICU admission; however, some missed cases of culture-positive early-onset sepsis have also been described. Methods All neonates with birth weight ≤ 1500 g, 34–36 weeks’ gestational age neonates with suspected intraamniotic infection and neonates with three clinical signs of early-onset sepsis or two signs and one risk factor for early-onset sepsis receive empirical antibiotics. Neonates ≥ 34 weeks’ gestational age with risk factors for early-onset sepsis or with one clinical indicator of early-onset sepsis undergo serial measurements of C-reactive protein and procalcitonin in the first 48–72 hours of life; they receive empirical antibiotics in case of abnormalities at blood exams with one or more clinical signs of early-onset sepsis. We therefore compared the number of patients for which antibiotics were needed, based on early-onset sepsis calculator, and the number of patients we treated with antibiotics during the study period. Comparisons between the groups were performed using McNemar’s test and statistical significance was set at p < 0.05. Results During the study period (1st January 2018-31st December 2018) 32/265 (12.1%) neonates ≥ 34 weeks’ gestational age at risk for early-onset sepsis received antibiotics within the first 12 hours of life. According to early-onset sepsis calculator: 55/265 (20.7%) patients would have received antibiotics with early-onset sepsis incidence 2/1000 live births (p < 0.0001); 44/265 (16.6%) patients would have received antibiotics with early-onset sepsis incidence 0.1/1000 live births (p < 0.025). One patient with culture-negative early-onset sepsis would not have received antibiotics with an early-onset sepsis incidence of 0.1/1000 live births. Conclusion Our evidence-based protocol for treatment decision-making of neonatal early-onset sepsis entails a further decrease of antibiotic overtreatment compared to early-onset sepsis risk calculator. No negative consequences for patients were observed.

scholarly journals Early-onset sepsis in term infants admitted to neonatal intensive care units (2011–2016)

2020 ◽  
Author(s):  
Laura Bech Polcwiartek ◽  
P. Brian Smith ◽  
Daniel K. Benjamin ◽  
Kanecia Zimmerman ◽  
Alycia Love ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Term Infants ◽  
Early Onset Sepsis

scholarly journals Managing Infants Exposed to Maternal Chorioamnionitis by the Use of Early-Onset Sepsis Calculator

2019 ◽  
Vol 6 ◽  
pp. 2333794X1983371 ◽  
Author(s):  
Vinay Sharma ◽  
Constance Adkisson ◽  
Kunal Gupta
Keyword(s):  
Gestational Age ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Complete Blood Count ◽  
Admission Rate ◽  
Antibiotic Use ◽  
Laboratory Evaluation ◽  
Utilization Rate ◽  
Early Onset Sepsis ◽  
Sepsis Calculator

Objective. To reduce neonatal intensive care unit admission rate (NAR) and antibiotic utilization rate (AUR) in ≥36 weeks gestational age infants exposed to maternal chorioamnionitis (MC) through the application of early-onset sepsis calculator (EOSCAL). Study Design. This is a single-center cohort study. All infants born ≥36 weeks gestational age and exposed to MC were compared for NAR, AUR, and laboratory evaluation rate (LER) 2 years after and 1 year before the implementation of EOSCAL. Results. There is a significant decrease in NAR ( P < .001), AUR ( P < .04), and LER for blood culture, complete blood count, and C-reactive protein ( P < .001) after implementation of EOSCAL. If infants received antibiotics, it was for significantly less number of doses ( P < .01). There was no increase in the readmission rate. Conclusion. Use of EOSCAL significantly decreases the rate of NAR, AUR, and LER in infants exposed to MC, without affecting readmission rates and late antibiotic use.

scholarly journals Value of Resistin in Early Onset Neonatal Sepsis

2017 ◽  
Vol 07 (01) ◽  
pp. e146-e150
Author(s):  
Abdurrahman Ozdemir ◽  
Yusuf Elgormus
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Clinical Signs ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Diagnostic Value ◽  
Sepsis Group ◽  
Control Group ◽  
Reactive Protein

AbstractThe diagnosis of neonatal sepsis is usually difficult because the sign and symptoms are nonspecific. Although C-reactive protein (CRP) and procalcitonin (PCT) are the most commonly used auxiliary tests, they are not reliable enough markers to be used for diagnosis of neonatal sepsis. This study aimed to evaluate the efficacy of resistin in diagnosing early onset neonatal sepsis and to compare its effectiveness to CRP and PCT. This prospective study was performed in the neonatal intensive care unit of Medicine Hospital between June and September 2016. Twenty-nine infants in the sepsis group and 33 infants in the control group were recruited. The Töllner scoring system was used for clinical signs. The hematologic parameters were evaluated using the Manroe and Rodwell scoring systems. The blood samples for CRP, PCT, and resistin were collected at admission (T0), and at 72 hours (T3). Mean plasma resistin level at T0 was 54.20 ± 39.3 ng/mL in the sepsis group and 34.92 ± 6.9 ng/mL in the control group. The sensitivity at T0 for resistin was 76%, and the specificity was 67%. The values of area under the curve (AUC) for CRP, PCT, and resistin were 0.84, 0.66, and 0.72, respectively. We found the diagnostic value of resistin to be lower than CRP, although its plasma levels were elevated. Therefore, we propose that resistin has limited value in diagnosis and follow-up of early-onset neonatal sepsis.

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