The Correlation of Antibacterial Peptides Concentration in Umbilical Cord Blood and Early-Onset Sepsis in Preterm Infants

Abstract Background: The role of serum LL37 in systemic inflammation has been confirmed, and the influence of it in umbilical cord blood to early-onset sepsis in preterm infants is currently being investigated.Results: The level of LL37 of sepsis group was higher than those of in control group (362.13±46.71 vs 248.13±83.30 ng/ml), the levels of CRP, WBC and MPV in sepsis group were higher than those of in control group (6.25±4.19 vs 2.89±2.77 mg/L; 17.60±12.35 vs 8.24±3.55×109/L; 11.10±1.11 vs 8.93±0.68 fL), the level of PLT was lower than those of in control group (175.20±38.51 vs 245.75±49.85×109/L) (P < 0.05). The expression of LL37 was negatively correlated with PLT (r = -0.9347, P < 0.0001), and positively correlated with MPV ((r =0.9463 , P < 0.0001), the expression of PLT was negatively correlated with MPV (r = -0.9641, P < 0.0001). The area under curve of LL37 for diagnosis of early-onset sepsis was 0.875, the prediction probability was 0.7, the sensitivity was 90.0% and the specificity was 80.0%.Conclusions：The higher level of LL37 in umbilical cord blood was associated with the development of early-onset sepsis in preterm infants.

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Study of umbilical cord blood culture in diagnosis of early-onset sepsis among newborns with high-risk factors

Journal of Clinical Neonatology ◽

10.4103/2249-4847.123092 ◽

2013 ◽

Vol 2 (4) ◽

pp. 169 ◽

Cited By ~ 6

Author(s):

MitulBabubhai Kalathia ◽

IlaMitulkumar Kalathia ◽

PrakashAshokbhai Shingala ◽

ParinNiranjanbhai Parmar ◽

YogeshNarenedrabhai Parikh

Keyword(s):

Risk Factors ◽

High Risk ◽

Blood Culture ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Early Onset ◽

High Risk Factors ◽

Early Onset Sepsis

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Eliminating Contamination in Umbilical Cord Blood Culture Sampling for Early-Onset Neonatal Sepsis

Frontiers in Pediatrics ◽

10.3389/fped.2021.794710 ◽

2021 ◽

Vol 9 ◽

Author(s):

Vilmaris Quinones Cardona ◽

Vanessa Lowery ◽

David Cooperberg ◽

Endla K. Anday ◽

Alison J. Carey

Keyword(s):

Quality Improvement ◽

Blood Culture ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Peripheral Blood ◽

Early Onset ◽

Clinical Sepsis ◽

Early Onset Sepsis ◽

Antibiotic Duration

Introduction: Despite the advantages of umbilical cord blood culture (UCBC) use for diagnosis of early onset sepsis (EOS), contamination rates have deterred neonatologists from its widespread use. We aimed to implement UCBC collection in a level III neonatal intensive care unit (NICU) and apply quality improvement (QI) methods to reduce contamination in the diagnosis of early onset sepsis.Methods: Single-center implementation study utilizing quality improvement methodology to achieve 0% contamination rate in UCBC samples using the Plan-Do-Study-Act (PDSA) model for improvement. UCBC was obtained in conjunction with peripheral blood cultures (PBC) in neonates admitted to the NICU due to maternal chorioamnionitis. Maternal and neonatal characteristics between clinical sepsis and asymptomatic groups were compared. Process, outcome, and balancing measures were monitored.Results: Eighty-two UCBC samples were collected in addition to peripheral blood culture from neonates admitted due to maternal chorioamnionitis. Ten (12%) neonates had a diagnosis of clinical sepsis. All PBCs were negative and 5 UCBCs were positive in the study period. After 2 PDSA cycles, there was special cause variation with improvement in the percent of contaminated samples from 7.3 to 0%. There was no change in antibiotic duration among asymptomatic neonates.Conclusions: Implementation of UCBC for the diagnosis of EOS in term infants is feasible and contamination can be minimized with the implementation of a core team of trained providers and a proper sterile technique without increasing antibiotic duration.

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Iron metabolism disorder and oxidative damage levels in placenta are involved in preeclampsia

Archives of Medical Science ◽

10.5114/aoms/144629 ◽

2021 ◽

Author(s):

Jianying Yan ◽

Jie Dong ◽

Xiaoqian Lin ◽

Lichun Chen ◽

Zhuanji Fang ◽

...

Keyword(s):

Cord Blood ◽

Pregnant Women ◽

Blood Sample ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Early Onset ◽

Late Onset ◽

Control Group ◽

Cord Blood Sample ◽

Stress Injury

IntroductionTo explore the role of ferritin in placenta, serum and umbilical cord blood of pregnant women and the changes of oxidative stress injury as well as cell apoptosis in placenta in the pathogenesis of preeclampsia (PE).Material and methodsSixty pregnant women with severe PE were assigned into early-onset and late-onset PE group. Another 60 cases of normal late pregnant women with similar gestational weeks were divided into early-onset and late-onset control group. Maternal serum and fetal umbilical cord blood ferritin content was determined by automatic biochemical immunoassay system; mRNA expression levels of ferritin and ferritin heavy chain (FTH) were detected by reverse transcription real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). Western Blot was used to detect the relative expression level of ferritin and apoptosis; the contents of total superoxide dismutase (T-SOD) and malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) were detected by colorimetry.ResultsSerum uric acid (UA) and creatinine (Cr) levels of PE groups were significantly higher when compared to the controls. The serum ferritin levels in blood sample and umbilical cord blood sample were significantly higher relative to the controls. However, the mRNA and protein levels of ferritin levels in placenta samples were significantly lower compared with the controls. The placental cleaved caspase-3, Bcl-2 levels were significantly lower than the early onset PE group. The levels of GSH-Px and MDA in placenta were significantly higher.ConclusionsThese results may assist understanding the pathogenesis of PE and provide potential biomarkers for diagnosis of PE.

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Potential Impact of Umbilical-Cord-Blood Procalcitonin-Based Algorithm on Antibiotics Exposure in Neonates With Suspected Early-Onset Sepsis

Frontiers in Pediatrics ◽

10.3389/fped.2020.00127 ◽

2020 ◽

Vol 8 ◽

Author(s):

Noémie Huetz ◽

Elise Launay ◽

Géraldine Gascoin ◽

Bertrand Leboucher ◽

Christophe Savagner ◽

...

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Early Onset ◽

Early Onset Sepsis ◽

Potential Impact

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Umbilical Cord Procalcitonin to Detect Early-Onset Sepsis in Newborns: A Promising Biomarker

Frontiers in Pediatrics ◽

10.3389/fped.2021.779663 ◽

2021 ◽

Vol 9 ◽

Author(s):

O. R. E. Dongen ◽

L. M. van Leeuwen ◽

P. K. de Groot ◽

K. Vollebregt ◽

I. Schiering ◽

...

Keyword(s):

Risk Factors ◽

Cord Blood ◽

Antibiotic Treatment ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Early Onset ◽

Antibiotic Administration ◽

Reactive Protein ◽

Early Onset Sepsis ◽

Reliable Marker

Background: Up to 7% of neonates born in high-income countries receive antibiotics for suspected early-onset sepsis (EOS). Culture-proven neonatal sepsis has a prevalence of 0.2%, suggesting considerable overtreatment. We studied the diagnostic accuracy of umbilical cord blood and infant blood procalcitonin (PCT) in diagnosing EOS to improve antibiotic stewardship.Methods: Umbilical cord blood PCT was tested in newborns ≥ 32 weeks of gestation. Groups were defined as following: A) culture-proven or probable EOS (n = 25); B) Possible EOS, based on risk factors for which antibiotics were administered for <72 h (n = 49); C) Risk factor(s) for EOS without need for antibiotic treatment (n = 181); D) Healthy controls (n = 74). Additionally, venous or capillary blood PCT and C-reactive protein (CRP) were tested if blood drawing was necessary for standard care.Results: Between June 2019 and March 2021, 329 newborns were included. Umbilical cord blood PCT was significantly higher in group A than in group C and D. No difference between venous or arterial samples was found. Sensitivity and specificity for cord blood procalcitonin were 83 and 62%, respectively (cut-off 0.1 ng/mL). Antepartum maternal antibiotic administration was associated with decreased PCT levels in both cord blood and infant blood directly postpartum in all groups combined.Conclusion: Umbilical cord blood PCT levels are increased in newborns ≥32 weeks with a proven or probable EOS and low in newborns with risk factors for infection, but PCT seems not a reliable marker after maternal antibiotic treatment. PCT could be useful to distinguish infected from healthy newborns with or without EOS risk factors.

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Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis

Pediatric Research ◽

10.1038/s41390-021-01792-0 ◽

2021 ◽

Author(s):

Thomas H. Dierikx ◽

Anton H. L. C. van Kaam ◽

Tim G. J. de Meij ◽

Ralph de Vries ◽

Wes Onland ◽

...

Keyword(s):

Systematic Review ◽

Blood Culture ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Early Onset ◽

Meta Analysis ◽

Early Onset Sepsis

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Acute life-threatening cardiovascular toxicity with umbilical cord blood infusion: The role of dextran

American Journal of Hematology ◽

10.1002/ajh.21797 ◽

2010 ◽

Vol 85 (9) ◽

pp. 722-724 ◽

Cited By ~ 10

Author(s):

Robert W. Ma ◽

John M. Kwan ◽

David D. Ma ◽

Keith C. Fay

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Cardiovascular Toxicity ◽

Life Threatening

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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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