Use of C-Reactive Protein (CRP) and haematological score to predict positive blood cultures in sepsis
Cut Adeya Adella in Stem Cell Oncology, 2018
The definitive diagnosis of neonatal sepsis is made by isolating the causative pathogens, commonly from blood cultures (Gotoff, 2002). Nevertheless, bacterial growth in culture requires time and it is not always possible to isolate the causative agents (Shane & Stoll, 2014). Other commonly used diagnostic tests include total and differential White Blood Cell (WBC) count, absolute and immature neutrophil counts, the ratio of Immature-to-Total neutrophils (IT ratio), Procalcitonin (PCT) and C-Reactive Protein (CRP) (Shane et al., 2017; Stocker et al., 2010; Canpolat et al., 2011). However, the availability of some of these tests is often limited to central hospitals. Another approach is to use a Haematological Scoring System (HSS), developed to facilitate the diagnosis of neonatal sepsis (Shane et al., 2017).
Neonatal sepsis
Prem Puri in Newborn Surgery, 2017
Management of neonatal sepsis includes supportive care, source control, and administration of appropriate antibiotics. Significant improvement in the morbidity and mortality of adult and pediatric sepsis has been achieved through goal-directed resuscitation (see Figure 20.5).57 Unfortunately, the “goal” of resuscitation is not as clear in the neonatal population as it is in adults.58 At birth, newborns carry a “backpack” of extra salt and water to carry them through the transition to extrauterine life.59 During this transition and early neonatal life, many hemodynamic parameters such as blood pressure do not have clear “normal” values.60 In addition, immature cardiovascular and endocrine systems may blunt the appropriate stress response in newborns, making vasopressor, inotrope, calcium, and hormone replacement necessary.61 Finally, aggressive fluid resuscitation is associated with a significant risk of reopening the ductus arteriosus and potentially worsening perfusion.62 Nevertheless, fluid resuscitation, vasopressor use, calcium replacement, and endocrine replacement are key components of the therapeutic armamentarium for achieving adequate tissue perfusion.63,64
Maternal Sepsis
Sanjeewa Padumadasa, Malik Goonewardene in Obstetric Emergencies, 2021
Prompt administration of broad-spectrum IV antibiotics, e.g. ceftriaxone, metronidazole and gentamicin, is essential to prevent both maternal and fetal complications. Neonatal sepsis is reduced by up to 80% with intrapartum antibiotic treatment. The currently used standard antibiotic regimens do not cover Ureaplasma urealyticum, which is one of the most rampant microorganisms implicated in the pathogenesis of intraamniotic infection. At the same time, specific coverage against ureaplasma (with macrolide antibiotics) has not been found to improve the outcome in intraamniotic infection. Antipyretics, e.g. paracetamol, should be administered.
Current and emerging treatments for neonatal sepsis
Published in Expert Opinion on Pharmacotherapy, 2020
Federico Carbone, Fabrizio Montecucco, Amirhossein Sahebkar
Data from large clinical studies and meta-analyses on neonatal sepsis support the efficacy of supplementation or replacement therapy with proteins, peptides, and probiotics naturally transferred to the infant from maternal milk. Conversely, other direct approaches targeting the immune system were not proved to have a potential clinical relevance, which might be due to the lack of knowledge on the pathophysiology of neonatal sepsis. Neonatal sepsis is indeed an extremely heterogeneous and dynamic condition in which microbial pathogens, immune response, and clinical presentation change according to gestational age, birth weight, type of feeding, as well as maternal and environmental factors. The lack of validated biomarkers makes patient stratification even more difficult. Therefore, future studies must take into account such diversities and design targeted approaches.
Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia
Published in Annals of Medicine, 2023
Tiewei Li, Xiaojuan Li, Zhiwei Zhu, Xinrui Liu, Geng Dong, Zhe Xu, Min Zhang, Ying Zhou, Jianwei Yang, Junmei Yang, Panpan Fang, Xiaoliang Qiao
The neonate’s lung is susceptible to microorganisms infection, which can lead to pneumonia [1,2]. Neonatal pneumonia is infectious lung disease with high morbidity and mortality worldwide [3,4]. The onset of neonatal pneumonia may be within hours of birth and part of a generalized sepsis syndrome. Neonatal sepsis is a severe bloodstream infection associated with a systemic inflammatory response and life-threatening organ system dysfunction [5]. Early recognition of sepsis and early treatment is encouraged by the Surviving Sepsis Campaign Physician’s management guidelines [6]. Recently, blood culture tests are the gold standard for diagnosing neonatal sepsis [7]. However, blood culture tests have a 48–72 h reporting delay and a low positive detection rate of pathogenic microorganisms [7]. Therefore, finding new biomarkers to distinguish sepsis from pneumonia in neonates is critical.
Assessment of relationship between serum vascular adhesion protein-1 (VAP-1) and gestational diabetes mellitus
Published in Biomarkers, 2019
Burcu Dincgez Cakmak, Betul Dundar, Fatma Ketenci Gencer, Durkadin Elif Yildiz, Feyza Bayram, Gulten Ozgen, Burcu Aydin Boyama
BMI was calculated by dividing the weight to the square of height (kg/m2). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were calculated as neutrophil and platelet count divided by absolute lymphocyte count. Moreover, perinatal outcomes such as delivery mode, gestational week at delivery, presence of macrosomia, birth weight, presence of respiratory distress syndrome (RDS) and neonatal sepsis, Apgar scores at first and fifth minutes, neonatal intensive care unit (NICU) admission were recorded at perinatal period. RDS was diagnosed as respiratory distress, tachypnoea, nasal flaring, grunting and a grainy shadow, air bronchogram, and white lung in chest x-ray. Neonatal sepsis was established if at least three of the followings were present: lethargy, temperature instability, respiratory rate above 70 per minutes, feeding intolerance, abdominal distension and heart rate disorders (>190 or <90 beats per minutes). Neonates with transient problems need cardiorespiratory monitoring, severe jaundice, preterms below 32 weeks of gestation, RDS, neonatal sepsis were admitted to NICU.
Related Knowledge Centers
- Bronchiolitis
- Meningitis
- Pneumonia
- Pyelonephritis
- Respiratory Failure
- Gastroenteritis
- Neonatal Infection
- Infant
- Bloodstream Infections
- Complete Blood Count