Late onset neonatal sepsis detection in newborn infants via multiple physiological streams

2013 ◽  
Vol 28 (1) ◽  
pp. e11-e12 ◽  
Author(s):  
Carolyn McGregor ◽  
Christina Catley ◽  
James Padbury ◽  
Andrew James
Keyword(s):  
Neonatal Sepsis ◽  
Late Onset ◽  
Newborn Infants ◽  
Sepsis Detection

scholarly journals nSeP: immune and metabolic biomarkers for early detection of neonatal sepsis—protocol for a prospective multicohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050100
Author(s):  
Mallinath Chakraborty ◽  
Patrícia R S Rodrigues ◽  
W John Watkins ◽  
Angela Hayward ◽  
Alok Sharma ◽  
...  
Keyword(s):  
Research Ethics ◽  
Neonatal Sepsis ◽  
Large Scale ◽  
Late Onset ◽  
Newborn Infants ◽  
Ethics Committee ◽  
Suspected Sepsis ◽  
New Host ◽  
Research Ethics Committee ◽  
Study Results

IntroductionDiagnosing neonatal sepsis is heavily dependent on clinical phenotyping as culture-positive body fluid has poor sensitivity, and existing blood biomarkers have poor specificity.A combination of machine learning, statistical and deep pathway biology analyses led to the identification of a tripartite panel of biologically connected immune and metabolic markers that showed greater than 99% accuracy for detecting bacterial infection with 100% sensitivity. The cohort study described here is designed as a large-scale clinical validation of this previous work.Methods and analysisThis multicentre observational study will prospectively recruit a total of 1445 newborn infants (all gestations)—1084 with suspected early—or late-onset sepsis, and 361 controls—over 4 years. A small volume of whole blood will be collected from infants with suspected sepsis at the time of presentation. This sample will be used for integrated transcriptomic, lipidomic and targeted proteomics profiling. In addition, a subset of samples will be subjected to cellular phenotype and proteomic analyses. A second sample from the same patient will be collected at 24 hours, with an opportunistic sampling for stool culture. For control infants, only one set of blood and stool sample will be collected to coincide with clinical blood sampling. Along with detailed clinical information, blood and stool samples will be analysed and the information will be used to identify and validate the efficacy of immune-metabolic networks in the diagnosis of bacterial neonatal sepsis and to identify new host biomarkers for viral sepsis.Ethics and disseminationThe study has received research ethics committee approval from the Wales Research Ethics Committee 2 (reference 19/WA/0008) and operational approval from Health and Care Research Wales. Submission of study results for publication will involve making available all anonymised primary and processed data on public repository sites.Trial registration numberNCT03777670

Diagnostic Value of Urine sTREM-1 and Urine C-reactive Protein for Infants with Late Onset Neonatal Sepsis

2019 ◽  
Vol 15 (02) ◽  
pp. 072-078
Author(s):  
Senem Alkan Ozdemir ◽  
Ruya Colak ◽  
Ezgi Yangin Ergon ◽  
Sebnem Calkavur
Keyword(s):  
Neonatal Sepsis ◽  
Predictive Value ◽  
Late Onset ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Late Onset Sepsis ◽  
Noninvasive Markers ◽  
Serum Crp ◽  
Sepsis Detection

Abstract Objective Noninvasive markers have been increasingly used as a diagnostic marker for sepsis detection and monitoring of the disease. The aim of this observational, prospective pilot study was to investigate the diagnostic performance of urinary soluble triggering receptor expressed on myeloid cells (sTREM-1) and urine C-reactive protein (CRP) levels in the late onset neonatal sepsis and to compare them with serum CRP levels. Materials and Methods Sixty-six infants with clinical sepsis were included. Urine sTREM-1 and urine CRP were collected at the diagnosis of late-onset sepsis. All laboratory investigations were also noted from the infants. Results There were no significant differences between characteristics of the infants. Culture-positive neonates had significantly higher urine sTREM-1 than culture-negative neonates (p < 0.001). Using a cut-off point for urine sTREM-1 of 129 pg/mL, the sensitivity was 0.63, the specificity was 0.84, positive predictive value was 0.80, negative predictive value was 0.70. Urine sTREM-1 and urine CRP were recollected on the seventh day of sepsis treatment and it was found that the levels of sTREM-1 and CRP decreased. Conclusion This is the first study in the literature which evaluates the place of urine sTREM-1 and urine CRP in the diagnosis of neonatal sepsis. Urine sTREM-1 and urine CRP may be useful in the diagnosis of sepsis and in evaluating the effect of antibiotic treatment.

scholarly journals Neonatal sepsis-blood culture, antibiotic stewardship and clinico-bacteriological study

2020 ◽  
Vol 7 (12) ◽  
pp. 2376
Author(s):  
Purva Shah ◽  
Ketan Gadhvi ◽  
Bharat Muliya ◽  
Khushi Shah
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Newborn Infants ◽  
Tertiary Hospital ◽  
Resistance Pattern ◽  
Bacteriological Study ◽  
Mortality And Morbidity ◽  
Early Onset Sepsis ◽  
Septic Focus

Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants less than 28 days old. It continues to remain a leading cause of morbidity and mortality among infants, especially in middle and lower-income countries. Neonatal sepsis is divided into 2 groups based on the time of presentation after birth: early-onset sepsis and late-onset sepsis.Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the neonates admitted with positive septic screen, neonates admitted with suspected clinical sepsis (temperature >990F or <950F, respiratory rate more than 60 per minute, change in behavior, abnormal cry, not accepting feed, drowsy or unconscious, septic focus on skin or umbilicus, diarrhea and seizures) and neonates admitted with culture positive sepsis.Results: As per this research, neonatal sepsis has more male preponderance, with more commonly occurring in low birth weights and preterm. Klebsiella, Staphylococcus aureus and Pseudomonas being the most isolated organisms. Their resistance pattern, antibiotic profile and newer trends also came across.Conclusions: Neonatal sepsis comes as one of the major causes of mortality and morbidity of the newborns admitted. By this research, analyzing the sex, age, gestational weeks, organism isolated and the antibiotic profile, emerging new resistance and newer useful antibiotics can thus be studied and can be taken as a base for further study as well as evaluation of the same, along with also guiding to manage and treat neonatal sepsis better.

Resistive Index in Late-Onset Neonatal Sepsis

2018 ◽  
Vol 32 (4) ◽  
pp. 93-97
Author(s):  
Rameshwor Yengkhom ◽  
Pradeep Suryawanshi ◽  
Snehal Ingale ◽  
Bhvya Gupta ◽  
Sujata Deshpande
Keyword(s):  
Cerebral Artery ◽  
Neonatal Sepsis ◽  
Anterior Cerebral Artery ◽  
Late Onset ◽  
Perinatal Asphyxia ◽  
Newborn Infants ◽  
Resistive Index ◽  
Genetic Syndromes ◽  
Hemodynamic State ◽  
The Mean

Background and Objectives: Hemodynamics in neonatal sepsis is complex and poorly understood. Several studies have reported conflicting findings on cerebral blood flow (CBF) in sepsis from severely increased flow to severely decreased flow. The objective of our study was to study CBF by measuring the resistive index (RI) of the anterior cerebral artery in late-onset neonatal sepsis (LONS). Methods: All newborn infants admitted in our neonatal intensive care unit with suspected LONS during the period from January 2017 to December 2017 underwent point-of-care transcranial Doppler ultrasonography to measure the RI of the anterior cerebral artery within 24 h of clinical presentation before starting inotropes if at all required. Infants with congenital heart disease, perinatal asphyxia, major congenital malformations, and genetic syndromes were excluded. Neonates with positive culture were included in the final analysis. Results: Of 89 suspected LONS, 33 were culture positive and were analyzed. The mean admission weight was 2.33 ± 0.76 kg. The mean gestational age was 33.5 ± 3.4 wk. Most common organism isolated was Klebsiella pneumoniae (82%). The RI was high in 54.5% (17 of 33) and normal in 45.5% (15 of 33) cases. Conclusions: LONS is a unique and complex hemodynamic state and we found it associated with the high RI indicating decreased CBF. A larger study may help in more understanding of this unique hemodynamic association.

scholarly journals Late-onset neonatal sepsis in preterm infants with birth weight under 1.500 g

2015 ◽  
Vol 36 (4) ◽  
pp. 84-89 ◽  
Author(s):  
Stella Marys Rigatti Silva ◽  
Giordana de Cássia Pinheiro da Motta ◽  
Cristiane Raupp Nunes ◽  
Juliana Machado Schardosim ◽  
Maria Luzia Chollopetz da Cunha
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Newborn Infants ◽  
University Hospital ◽  
Hospital Data ◽  
Coagulase Negative Staphylococci ◽  
The University ◽  
Preterm Newborns

Objective: the research objective was to characterize preterm infants with birth weight under 1500 g, and to identify the incidence of late-onset neonatal sepsis among this population. Methods: a prospective cohort study with a sample of 30 preterm newborns that weighed under 1500 g and were hospitalized in the NICU of the university hospital. Data were collected from January to December 2013 using a structured instrument. Results: of the 30 neonates included in the study, 14 developed late-onset neonatal sepsis with a prevalence of coagulase-negative staphylococci. Conclusions: the incidence of late-onset neonatal sepsis indicates a vulnerability in preterm infants due to immunological immaturity. These results reveal that knowledge of the profile of newborn infants admitted to the NICU and the risk factors to which they are exposed are central to the planning of nursing care for these patients. Future studies should address strategies for preventing nosocomial infection.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

Diagnostic value of assessment of Serum Cortisol, Hepcidin and Thyroid Hormone Levels in Neonates with Late Onset Sepsis

2020 ◽  
Vol 20 ◽  
Author(s):  
Adel Hagag ◽  
Mohamed S Elfarargy ◽  
Reham Lyonis ◽  
Ghada M Al-Ashmawy
Keyword(s):  
Thyroid Hormones ◽  
Antibiotic Therapy ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Serum Cortisol ◽  
Control Group ◽  
Serum Free ◽  
Group I ◽  
Late Onset Sepsis ◽  
Serum Hepcidin

Background: Neonatal sepsis is a clinical syndrome characterized by symptoms and signs of infection in the first twenty eight days of life. Serum thyroid, cortisol and hepcidin are affected by neonatal sepsis. Aim of the work: The aim of this study was to assess the predictive value of serum thyroid hormones including free triiodothyronine (free TT3) and free tetraiodothyronine (free TT4), serum cortisol and hepcidin levels through comparison of their concentrations between normal neonates and neonates with high probable late onset sepsis. Patients and Methods: This case control study was carried out on 40 neonates with suspected high probable late onset neonatal sepsis based on clinical and laboratory finding who were admitted to NICU of Pediatric Department, Tanta University, Egypt in the period from April 2017 to May 2019 (group I) and 40 healthy neonates matched in age and sex as a control group (group II). For patients and controls; blood culture, highly sensitive C‑reactive protein (H-s CRP), serum hepcidin, serum cortisol and thyroid hormones levels including free TT3 and free TT4 were assessed. Results: There were no significant differences between studied groups as regard weight, gestational age, sex and mode of delivery. H-s CRP, serum cortisol and hepcidin were significantly higher in group I than group II while serum free TT3 and free TT4 were significantly lower in group I compared with controls. There was significantly lower H-s CRP, serum hepcidin and cortisol and significantly higher serum free TT3 and free TT4 in group I after antibiotic therapy compared to the same group before treatment while there were no significant differences between group I after antibiotic therapy and control group as regard the same parameters. There were significant positive correlation between H-s CRP and serum hepcidin and cortisol in group I while there was significant negative correlation between H-s CRP and free TT3 and free TT4. ROC curve of specificity and sensitivity of H-s CRP, serum hepcidin, cortisol, free TT3 and free TT4 in prediction of neonatal sepsis shows that serum hepcidin had the highest sensitivity and specificity with 95% and 90% respectively followed by serum cortisol, H-s CRP, free TT3 and lastly free TT4. Conclusion and recommendations: Neonates with high probable sepsis had significantly higher serum cortisol and hepcidin and significantly lower free TT3 and free TT4 compared with healthy neonates. These findings may arouse our attention about the use of these markers in diagnosis of in neonatal sepsis which can lead to early treatment and subsequently better prognosis.

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