Serum Pentraxin 3 Concentration in Neonatal Sepsis

Objective Neonatal sepsis is one of the most important causes of neonatal morbidity and mortality. Symptoms and signs of neonatal sepsis can be silent; therefore, laboratory investigation is necessary in cases of doubt or if there are risk factors. Early diagnosis is important for early intervention and treatment. The most valuable method for diagnosis is blood culture; however, false positivity due to contamination or false negativity despite ongoing fatal bacterial infections can be seen. Pentraxin 3 is a prototype of the long pentraxin family. It has some differences from C-reactive protein (CRP) in terms of gene organization and localization and production site. It is effective in the early phase of inflammation and it is detected as an early marker of sepsis in adults. The aim of this study was to investigate whether pentraxin 3 can be used as a marker in neonatal sepsis. Materials and Methods Thirty newborns with suspected sepsis with antenatal history or the presence of clinical signs of sepsis, such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, or metabolic acidosis, were enrolled in the study as a case group, and 28 healthy newborns were included as a control group. Serum pentraxin 3, procalcitonin, CRP, and hemogram in the study group and serum procalcitonin and pentraxin in the control group were examined. Results Serum pentraxin 3 (pg/mL) and serum procalcitonin (ng/mL) levels were 2,273.82 ± 1,260.75 and 0.86 ± 0.52 in the case group and 957.41 ± 268.00 and 0.19 ± 0.18 in the control group (p < 0.001 for both), respectively. Conclusion The present study showed that serum pentraxin 3 levels may be a useful marker in the diagnosis of neonatal sepsis.

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Perfusion Index: A Noninvasive Tool for Clinical Decision in Neonates with Suspected Sepsis?

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1649340 ◽

2018 ◽

Vol 13 (03) ◽

pp. 247-251

Author(s):

Alessandro Perri ◽

Giovanni Barone ◽

Anthea Bottoni ◽

Eloisa Tiberi ◽

Enrico Zecca ◽

...

Keyword(s):

Antibiotic Therapy ◽

Clinical Signs ◽

Perfusion Index ◽

Control Group ◽

P Value ◽

Case Group ◽

C Reactive Protein ◽

Suspected Sepsis ◽

Suspected Infection ◽

Reactive Protein

Aim This article aims to assess whether perfusion index is significantly different in infants with positive C-reactive protein and/or positive cultures compared with a control group. Methods This was a prospective observational cohort study. Perfusion index was evaluated in 80 neonates at the start of antibiotic therapy for suspected sepsis. Antibiotic therapy was started based on the antenatal history or the presence of clinical signs of sepsis such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, and metabolic acidosis. A case group of 23 neonates with abnormal C- reactive protein (> 10 mg/L) and/or positive cultures (blood, liquor, or bronchoalveolar lavage cultures) was compared with a control group of 23 neonates. Results Cases (mean gestational age [GA], 33 ± 5) and controls (mean GA, 33 ± 5) were matched according to the following criteria: GA (±2 weeks), postmenstrual age (±2 weeks), early (< 72 hours), or late (> 72 hours) onset of suspected infection. Mean perfusion index was 0.8 ± 0.3 in the case group and 1.2 ± 0.4 in the control group; p-value of < 0.001. Conclusions Perfusion index can be considered a noninvasive, reproducible, and easy-to-apply tool for early diagnosis of a neonatal acute inflammation in course of sepsis.

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Value of Resistin in Early Onset Neonatal Sepsis

Journal of Child Science ◽

10.1055/s-0037-1608713 ◽

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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Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20183527 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1898 ◽

Cited By ~ 2

Author(s):

Ratana Ram Choudhary ◽

Mohan Makwana ◽

Harish Kumar Mourya ◽

Jagdish Dabi ◽

Kartika Gulati

Keyword(s):

Platelet Count ◽

Blood Culture ◽

Neonatal Sepsis ◽

Neonatal Morbidity ◽

Signs And Symptoms ◽

Control Group ◽

Case Group ◽

Platelet Indices ◽

Sepsis Screen ◽

Sepsis Screening

Background: Neonatal sepsis is major cause of neonatal morbidity and mortality worldwide. Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. Platelet indices are one such set of parameters which can be helpful in the future diagnosis of neonatal sepsis. This study was aimed to evaluate the significance of platelet indices either alone or in combination with existing sepsis screen as a marker of neonatal sepsis.Methods: Neonates admitted in the neonatal unit of Hospital and showing signs and symptoms of sepsis, and/or born to mothers with risk factor for sepsis were included in this study. Investigations sent for all these neonates included blood culture, sepsis screen (CRP, micro ESR, TLC, ANC, IT ratio) and platelet indices (Platelet count, MPV, PDW).Results: In present study, 81.12% neonates in case group had platelet count less than 1.5lacs/mm3 while in control group 20.91% neonates only had the same. This difference was statistically significant, (p<0.0001). Similarly, 70.91% neonates in case group had MPV more than >10.8 fl whereas in control group only 26.53% neonates had the same, with difference was statistically significant, (p<0.0001) Similarly, 65.81% neonates in case group and 34.69% in control group had PDW more than 19.1fl and this difference was statistically significant, (p=0.0001).Conclusions: High PDW, high MPV and low platelet count are more associated with neonatal sepsis. So, platelet and its indices may be used as a sensitive marker to identify septic babies and it may be combined with existing sepsis screen to specifically exclude non-septic case.

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Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0041-1726118 ◽

2021 ◽

Vol 16 (03) ◽

pp. 099-105

Author(s):

Nuriye Asli Melekoglu ◽

Seyma Yasar ◽

Mehmet Keskin

Keyword(s):

Neonatal Sepsis ◽

Diagnostic Marker ◽

Diagnostic Value ◽

Tertiary Hospital ◽

Control Group ◽

Roc Curve Analysis ◽

Suspected Sepsis ◽

Sepsis Diagnosis ◽

Reactive Protein ◽

Delta Neutrophil Index

Abstract Objective Sepsis diagnosis is challenging due to nonspecific symptomatology in newborns. Timely diagnosis is essential for reducing sepsis-related morbidity and mortality. This study was performed to determine the diagnostic value of the delta neutrophil index (DNI) for detection of neonatal sepsis and to compare its efficacy with other conventional markers. Methods This study was conducted at a tertiary hospital in newborns with confirmed sepsis (n = 59), suspected sepsis (n = 46), and in age- and weight-matched controls (n = 49). DNI, white blood cell count, C-reactive protein (CRP) level, and platelet measurements were determined, and blood cultures were performed at the onset of symptoms. Results The mean DNI was significantly higher in confirmed and clinical sepsis groups compared with the control group. (6.9 ± 9.3, 1.9 ± 2.1, and 0.4 ± 0.5, respectively, p < 0.001). ROC curve analysis also showed that the combination of DNI and CRP had the highest sensitivity (86%), specificity (100%), and positive predictive value (100%) for predicting neonatal sepsis. DNI values were significantly higher in nonsurvivors (p < 0.05). Conclusion DNI could be used as a reliable diagnostic marker for neonatal sepsis, and high DNI could predict sepsis development and unfavorable outcomes. The diagnostic capability of DNI may be increased by assessing CRP measurements simultaneously.

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The importance of determining procalcitonin and C reactive protein in different stages of sepsis

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2010.2737 ◽

2010 ◽

Vol 10 (1) ◽

pp. 60-64 ◽

Cited By ~ 7

Author(s):

Zana Baruti-Gafurri ◽

Hidajet Paçarizi ◽

Bukurije Zhubi ◽

Luljeta Begolli ◽

Valdete Topçiu

Keyword(s):

Septic Shock ◽

Systemic Inflammatory Response Syndrome ◽

Neonatal Sepsis ◽

Bacterial Infections ◽

Control Group ◽

C Reactive Protein ◽

Reactive Protein ◽

Purulent Meningitis ◽

Systemic Infections ◽

Diagnostic Importance

Rapid and early diagnosis of systemic infections is very important for acting on time with an adequate therapy. The aim of this study is to determine the diagnostic importance of procalcitonin (PCT) and C-reactive protein (CRP) of bacterial infections in different stages of sepsis.PCT and CRP have been determined in 45 newborns, 1-21 days of age, with different stages of sepsis, in the centre for prematurely born neonates. These parameters have also been determined for control group, in which there were 10 healthy newborns. Procalcitonin values were significantly increased in neonates with septic shock (92,5 ng/mL; 6,06-200 ng/mL) compared to the systemic inflammatory response syndrome- SIRS (41 ng/mL; 0,28-200 ng/mL), neonatal sepsis (10,26 ng/mL; 1,08-111,3 ng/mL), neonatal sepsis and purulent meningitis (9,80 ng/mL; 4,3-18,9 ng/mL). The control group values were lower than 0,5 ng/mL. CRP is increased without statistical differences in all stages of sepsis in newborns with septic shock (93,2 mg/L; 6,0-196 mg/L) in cases with SIRS (45,64 mg/L; 6,0-147 mg/L), neonatal sepsis (70,02 mg/L; 6-177 mg/L), neonatal sepsis and purulent meningitis (61,98 mg/L; 24-192 mg/L). The average values for the control group were 4,7 mg/L. Procalcitonin is increased in all stages of sepsis with higher values in the septic shock. The increase of PCT levels is related to the severity, course of infection and prognosis of disease.

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cfDNA and DNases: New Biomarkers of Sepsis in Preterm Neonates—A Pilot Study

Cells ◽

10.3390/cells11020192 ◽

2022 ◽

Vol 11 (2) ◽

pp. 192

Author(s):

Moritz Lenz ◽

Thomas Maiberger ◽

Lina Armbrust ◽

Antonia Kiwit ◽

Axel Von der Wense ◽

...

Keyword(s):

Preterm Infants ◽

Neonatal Sepsis ◽

Early Onset ◽

Late Onset ◽

Dnase I ◽

Sepsis Group ◽

Preterm Neonates ◽

Control Group ◽

Suspected Sepsis ◽

Epidemiological Characteristics

Introduction: An early and accurate diagnosis of early onset neonatal sepsis (EONS) and late onset neonatal sepsis (LONS) is essential to improve the outcome of this devastating conditions. Especially, preterm infants are at risk. Reliable biomarkers are rare, clinical decision-making depends on clinical appearance and multiple laboratory findings. Markers of NET formation and NET turnover might improve diagnostic precision. Aim of this study was to evaluate the diagnostic value of NETs in sepsis diagnosis in neonatal preterm infants. Methods: Plasma samples of neonatal preterm infants with suspected sepsis were collected. Blood samples were assayed for markers of NET formation and NET turnover: cfDNA, DNase1, nucleosome, NE, and H3Cit. All clinical findings, values of laboratory markers, and epidemiological characteristics were collected retrospectively. Two subpopulations were created to divide EONS from LONS. EMA sepsis criteria for neonatal sepsis were used to generate a sepsis group (EMA positive) and a control group (EMA negative). Results: A total of 31 preterm neonates with suspected sepsis were included. Out of these, nine patients met the criteria for sepsis according to EMA. Regarding early onset neonatal sepsis (3 EONS vs. 10 controls), cfDNA, DNase I, nucleosome, and CRP were elevated significantly. H3Cit and NE did not show any significant elevations. In the late onset sepsis collective (6 LONS vs. 12 controls), cfDNA, DNase I, and CRP differed significantly compared to control group.

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VALIDITY OF C- REACTIVE PROTEIN IN DIAGNOSIS OF NEONATAL SEPSIS.

10.36106/ijsr/1506241 ◽

2020 ◽

pp. 1-4

Author(s):

Ghongade P. G. ◽

Khaire P. B.

Keyword(s):

Birth Weight ◽

Neonatal Sepsis ◽

Predictive Value ◽

Screening Test ◽

Treatment Strategies ◽

High Sensitivity ◽

C Reactive Protein ◽

Suspected Sepsis ◽

Adequate Treatment ◽

Reactive Protein

Background: Neonatal sepsis with its high incidence &grave prognosis, in spite of adequate treatment with modern antibiotics, has been a challenge for all times. Optimal diagnosis and treatment strategies are difficult to define. It is essential to diagnose early with laboratory investigation like serial CRP; so that a feasible, rapid and a relatively economic method to diagnose neonatal sepsis at earliest can be instituted even at basic health care level. hence a study was planned to find out the role of CRP against blood culture in early detection of neonatal sepsis. Aim & Objective: To evaluate Validity of C-Reactive Protein as a screening test in neonatal sepsis. Material and Method: This prospective study was carried out inpaediatric dept of medical college. 100 neonates (≤ 28 days) with suspected neonatal sepsis having a birth weight of ≥ 1000 grams admitted during a period from January 2020 to March 2020 were screened primarily with C-Reactive Protein. Serial level of CRPon the day of admission,2nd ,4th ,6th ,8th& 10th day was compared with the serial blood cultureon the day of admission,8th,15th& 21st day to establish the validity of CRP as a screening test.Data analysis carried out by Percentages, Chi Square test, Sensitivity, Specificity, Positive predictive value, Negative predictive value. Results: Amongst 100neonate 76% were early neonates,65% were low birth weight,CRP was having high sensitivity & specificity(78.57%,76.74% respectively). ROC analysis showed AUC 0.8 with p<0.001.Conclusion: CRP is a good screening test & establishes its validity in diagnosing suspected sepsis.

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Role of Serial C-reactive Protein (CRP) in Relation to Total Leucocyte Count, Platelet Count & Blood Culture for early Diagnosis of Neonatal Septicemia in Developing Countries

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i2.26032 ◽

2015 ◽

Vol 32 (2) ◽

pp. 61-65

Author(s):

Chiranjib Barua ◽

Md Nurul Anwar ◽

Md Shahidullah ◽

Shahadat Hossain ◽

Sharmila Barua ◽

...

Keyword(s):

Developing Countries ◽

Blood Culture ◽

Early Diagnosis ◽

Neonatal Sepsis ◽

Leucocyte Count ◽

Control Group ◽

Total Leucocyte Count ◽

C Reactive Protein ◽

Neonatal Septicemia ◽

Reactive Protein

Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occuring in the first 28 days of life. Neonatal septicemia is one of the major causes of neonatal death in developing countries. Early diagnosis and treatment can prevent neonatal mortality and morbidity. The present study includes: 1) usefulness of CRP (C-reactive protein), Total Leucocyte Count, Platelet Count and Blood Culture in early diagnosis of Neonatal Sepsis, 2) significance of serial CRP in diagnosis of neonatal sepsis. 3) the prognostic value of CRP in neonatal sepsis. This is a prospective study done in neonatal ward, Chittagong Medical College Hospital and carried out from January 2008 to January 2011. Sample size was 300. One hundred fifty neonates with suspected sepsis as cases and 150 healthy babies as control were enrolled in this study. Seventy two percent of cases neonates were preterm and low birth weight. Common risk factors for neonatal septicemia which were identified in this study; preterm (72%), low birth weight (72%), premature rupture membrane (60%), chorioamnionitis (26%) and maternal urinary tract infection (16%) . Out of 150 cases of suspected neonatal sepsis total 80.7%% had raised CRP, in initial sample 70.39% were CRP positive and in 2nd sample additional 9.31% case were CRP positive . In control group 91% were CRP negative. CRP was positive in 100% of culture proven sepsis. Sensitivity of CRP was 80.67% and specificity of CRP was 76.44%. Leucocytosis was observed in 7% of cases and leucopenia was found in 11% of cases. In 82 % cases leucocyte count was found normal. In control group, 95% had normal leucocyte count and 5% had leucocytosis but no leucopenia. Sensitivity of leucocyte count was 18% and specificity was 20.68%. Thrombocytopenia was found in 28% of case group. Out of 150 cases only 15.33% yielded growth of organisms in blood culture. Klebsiella was the most common pathogen isolated which was followed by E.coli and Strph. aureus. Sensitivity of blood culture was 15.33% and specificity was 100% Therefore serial CRP can be taken as alternative method for diagnosis of neonatal sepsis specially in developing countries where blood culture is not readily available.J Bangladesh Coll Phys Surg 2014; 32: 61-65

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The Potential Value of Plasma Receptor Interacting Protein 3 for Neonatal Sepsis Diagnosis

10.21203/rs.3.rs-300543/v1 ◽

2021 ◽

Author(s):

Chuchu Gao ◽

Zongtai Feng ◽

Lixia Wang ◽

Xingxing Zhao ◽

Kai Fu ◽

...

Keyword(s):

Neonatal Sepsis ◽

Diagnostic Value ◽

Sepsis Group ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Interacting Protein ◽

Sepsis Diagnosis ◽

Reactive Protein ◽

Potential Value ◽

Hs Crp

Abstract Background: Neonatal sepsis is a systemic inflammatory response syndrome in neonates. The molecular mechanism of neonatal sepsis remains incompletely clarified. The purpose of this study was to explore the potential value of receptor interacting protein 3 (RIP3) in neonatal sepsis.Methods: 93 neonates with sepsis and 93 neonates without infectious diseases were enrolled in this study from September 2019 to March 2021. Plasma RIP3 was detected by enzyme-linked immunosorbent assay (ELISA) and assessed along with whole blood hypersensitive C-reactive protein (hs-CRP) and platelet count (PLT). Differences of RIP3, hs-CRP and PLT between the two groups were compared. Changes of the three indicators in sepsis were also observed after treatment. The diagnostic value of indicators for neonatal sepsis was evaluated by receiver operating characteristic (ROC) curve.Results: In sepsis group, RIP3 and hs-CRP levels were significantly higher than those in control group (RIP3, p ＜ 0.0001; hs-CRP, p ＜ 0.0001), and PLT level was significantly lower than that in control group (p＜0.0001). After treatment, RIP3 and hs-CRP levels among septic survivors had a significant decrease (p＜0.0001) and PLT level had a significant improvement (p=0.0028). With RIP3＞15464.72 pg/mL, CRP>3.24 mg/L, PLT<205.00×109 /L as the positive criteria, the sensitivity of the three indicators in the diagnosis of neonatal sepsis was 68.8%, 64.5%, 59.1%, and the specificity was 91.4%, 82.8%, 79.6%, respectively. The combination of RIP3, CRP and PLT showed 76.3% sensitivity and 94.6% sensitivity.Conclusions: RIP3 may attribute to the early diagnosis and understanding therapeutic effect of neonatal sepsis. The combined detection of RIP3, CRP and PLT may be more effective than individual ones in the diagnosis of neonatal sepsis.

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Fever and laboratory profiles as predictors of serious bacterial infection in children

Paediatrica Indonesiana ◽

10.14238/pi52.6.2012.313-6 ◽

2012 ◽

Vol 52 (6) ◽

pp. 313

Author(s):

Ni Putu Veny Kartika Yantie ◽

BNP Arhana ◽

Purnomo Suryantoro

Keyword(s):

Bacterial Infection ◽

Bacterial Infections ◽

Statistical Significance ◽

Controlled Study ◽

Control Group ◽

Case Group ◽

Bacterial Gastroenteritis ◽

Leukocyte Counts ◽

Serious Bacterial Infections ◽

Tract Infections

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3􀁉15% of children with fever of 2: 39°C.Various laboratory parameters including increased C􀁉reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 month􀁉 18 years.Methods A case􀁉controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (non􀁉SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P 􀀁 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P 􀀁 0.012, respectively].Conclusion Fever 2: 39°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

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