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

2020 ◽  
Vol 8 ◽  
Author(s):  
Noémie Huetz ◽  
Elise Launay ◽  
Géraldine Gascoin ◽  
Bertrand Leboucher ◽  
Christophe Savagner ◽  
...  
2021 ◽  
Vol 9 ◽  
Author(s):  
Vilmaris Quinones Cardona ◽  
Vanessa Lowery ◽  
David Cooperberg ◽  
Endla K. Anday ◽  
Alison J. Carey

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.


2013 ◽  
Vol 2 (4) ◽  
pp. 169 ◽  
Author(s):  
MitulBabubhai Kalathia ◽  
IlaMitulkumar Kalathia ◽  
PrakashAshokbhai Shingala ◽  
ParinNiranjanbhai Parmar ◽  
YogeshNarenedrabhai Parikh

2021 ◽  
Author(s):  
Jiayu Miao ◽  
Ying Liu ◽  
Zengqing Li ◽  
Zhuxiao Ren ◽  
Zhicheng Zhong ◽  
...  

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.


2021 ◽  
Vol 9 ◽  
Author(s):  
O. R. E. Dongen ◽  
L. M. van Leeuwen ◽  
P. K. de Groot ◽  
K. Vollebregt ◽  
I. Schiering ◽  
...  

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 &lt;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.


Author(s):  
Thomas H. Dierikx ◽  
Anton H. L. C. van Kaam ◽  
Tim G. J. de Meij ◽  
Ralph de Vries ◽  
Wes Onland ◽  
...  

2021 ◽  
Vol 9 (3) ◽  
pp. 452-461
Author(s):  
  Dr. Mohammad Shakhawat Alam ◽  
Prof. M.A. Mannan ◽  
Dr. Sanjoy Kumer Dey ◽  
Dr. A Z M Raihanur Rahman ◽  
Prof. Mohammod Shahidullah

2020 ◽  
Vol 87 (10) ◽  
pp. 793-797 ◽  
Author(s):  
Ramraj Meena ◽  
Kailash Kumar Meena ◽  
Vivek Athwani ◽  
Sunil Gothwal ◽  
Ghan Shyam Bairwa ◽  
...  

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