scholarly journals Presepsin (Soluble CD14 Subtype) as an Early Marker of Neonatal Sepsis and Septic Shock: A Prospective Diagnostic Trial

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 580
Author(s):  
Carlo Pietrasanta ◽  
Andrea Ronchi ◽  
Claudia Vener ◽  
Chiara Poggi ◽  
Claudia Ballerini ◽  
...  
Keyword(s):  
Septic Shock ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Clinical Severity ◽  
Youden Index ◽  
Reactive Protein ◽  
Sepsis And Septic Shock ◽  
Sensitivity Specificity ◽  
Clinical Conditions ◽  
Diagnostic Trial

In the context of suspected neonatal sepsis, early diagnosis and stratification of patients according to clinical severity is not yet effectively achieved. In this diagnostic trial, we aimed to assess the accuracy of presepsin (PSEP) for the diagnosis and early stratification of supposedly septic neonates. PSEP, C-reactive protein (CRP), and procalcitonin (PCT) were assessed at the onset of sepsis suspicion (T0), every 12–24 h for the first 48 h (T1–T4), and at the end of antibiotic therapy (T5). Enrolled neonates were stratified into three groups (infection, sepsis, septic shock) according to Wynn and Wong’s definitions. Sensitivity, specificity, and area under the ROC curve (AUC) according to the severity of clinical conditions were assessed. We enrolled 58 neonates with infection, 77 with sepsis, and 24 with septic shock. PSEP levels were higher in neonates with septic shock (median 1557.5 pg/mL) and sepsis (median 1361 pg/mL) compared to those with infection (median 977.5 pg/mL) at T0 (p < 0.01). Neither CRP nor PCT could distinguish the three groups at T0. PSEP’s AUC was 0.90 (95% CI: 0.854–0.943) for sepsis and 0.94 (95% CI: 0.885–0.988) for septic shock. Maximum Youden index was 1013 pg/mL (84.4% sensitivity, 88% specificity) for sepsis, and 971.5 pg/mL for septic shock (92% sensitivity, 86% specificity). However, differences in PSEP between neonates with positive and negative blood culture were limited. Thus, PSEP was an early biomarker of neonatal sepsis severity, but did not support the early identification of neonates with positive blood culture.

scholarly journals Haematological Parameters in Neonatal Sepsis in a Tertiary Care Centre Study

2021 ◽  
Vol 8 (13) ◽  
pp. 751-754
Author(s):  
Pruthvi D ◽  
Pavan Ramarao Kulkarni ◽  
Uma Raghavendra Jamkhandi ◽  
Shivakumar Sanganagouda Inamdar
Keyword(s):  
Blood Culture ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neonatal Septicaemia ◽  
Sepsis Screen ◽  
Sensitivity Specificity ◽  
Culture Positive

BACKGROUND Neonatal septicaemia is a bacterial infection with positive blood culture in first four weeks of life. The early sepsis screen is vital as it detects earlier and benefits the clinician to treat the infection reducing neonatal mortality and morbidity. We wanted to evaluate various haematological screening parameters and C-reactive protein (CRP) in blood culture positive neonates in sepsis. METHODS This prospective study was conducted for a period of one year. Blood samples from hundred clinically suspected neonatal septicaemia cases were subjected to aerobic culture and sepsis screen tests like C-reactive protein, erythrocyte sedimentation ratio (ESR), total WBC count, absolute neutrophil count, immature / total neutrophil count (I / T) ratio and platelet count. The culture results were correlated with the sepsis screen tests. RESULTS Of the hundred cases studied, 18 % were blood culture positive and 66 % were males. Early onset septicaemia was more common, seen in 64 % of cases than late onset septicaemia (26 %) cases. Staphylococcus aureus was the commonest organism isolated in 38.46 % of cases followed by Klebsiella pneumoniae & E. Coli. Among the haematological parameters, the positivity was best with Creactive protein (94.44 %) followed by immature & mature neutrophil ratio (I / M) (94.44 %), I / T ratio (88.88 %) and the least with absolute neutrophil count (66.0 %). Any two or more parameters were positive in 94.44 % of the subjects. CONCLUSIONS Sepsis screen has good sensitivity, specificity and is a valuable aid for early diagnosis of neonatal septicaemia. Sepsis screen is simple, cost effective, less time consuming and easy to perform. As an individual test C-reactive protein has shown highest sensitivity, specificity and is a sensitive and responsive indicator of neonatal sepsis. KEYWORDS Blood Culture, Neonatal Septicaemia, Sepsis Screen

scholarly journals Diagnostic Significance of White Blood Cell Count and C-Reactive Protein in Neonatal Sepsis; Asella Referral Hospital, South East Ethiopia

2018 ◽  
Vol 12 (1) ◽  
pp. 209-217
Author(s):  
Abebe Sorsa
Keyword(s):  
Blood Culture ◽  
Blood Cell ◽  
White Blood Cell ◽  
Neonatal Sepsis ◽  
C Reactive Protein ◽  
Diagnostic Significance ◽  
Gram Negative ◽  
Reactive Protein ◽  
Wbc Count ◽  
Sensitivity Specificity

Introduction:Nowadays various biochemical markers, such as C-Reactive Protein (CRP), Procalcitonin and tumor necrosis factor alpha, have been proposed as a potential marker for screening neonatal sepsis. In the current study, we tried to see the diagnostic significance of White Blood Cell (WBC) count and CRP in diagnostic screening of neonatal sepsis.Methods:A prospective cross-sectional study was conducted from May 2016 to April 2017 in Asella Teaching and Referral Hospital. Data were entered into EPI-INFO version 3.5.1 for cleanup and then exported to SPSS version 17 for further analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were used to assess the accuracy of CRP and WBC count taking blood culture as gold standard.Results:Data of 303 neonates with clinical sepsis were analyzed. Positive CRP and abnormal WBC were reported in 136(45%) and 99(32.7%) of study subjects respectively. Blood culture turned to be positive in 88(29.4%) of study subjects. The Sensitivity, Specificity, PPV and NPV of WBC count were 59.5 %, 79.6%, 52%, 64.5% respectively while the sensitivity, specificity, PPV and NPV of CRP were 65.6%, 78%, 42% and 91% respectively. By combining both WBC and CRP, the sensitivity, specificity, PPV and NPV improve to 78.5%, 83%, 60% and 93% respectively. CRP positivity rate was comparable across gram positive and gram negative bacteria while high WBC count were more reported among gram positive sepsis than gram negative ( OR 4.8, (95% CI 1.45-15.87, P 0.01)Conclusion:Based on this study’s finding, it can be concluded that CRP alone or in combination with WBC count showed better diagnostic accuracy in neonatal sepsis.

scholarly journals Diagnostic Accuracy of C-Reactive Protein in Neonatal Sepsis

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Sidra Younis ◽  
Muhammad Ali Sheikh ◽  
Amjad Ali Raza
Keyword(s):  
Blood Culture ◽  
Diagnostic Accuracy ◽  
Neonatal Sepsis ◽  
High Sensitivity ◽  
Operational Definition ◽  
C Reactive Protein ◽  
Capillary Refill ◽  
Neonatal Deaths ◽  
Reactive Protein ◽  
Sensitivity Specificity

Sepsis is the most common cause of neonatal mortality and is responsible for 30-50% of total neonatal deaths each year in developing countries. The objective of the study was to determine the diagnostic accuracy of Creactive protein (CRP) in neonatal sepsis. Fifty nine consecutive patients with risk factors and clinical features suggestive of CRP sepsis were selected as per operational definition and fulfilling the inclusion and exclusion criteria. Detailed physical examination was carried out. Blood sample for culture and CRP was taken from all the patients. Results of blood culture and CRP were noted down in the performa. Statistical analysis was performed by SPSS software version 16. Among selected patients 31/59 (52.5%) were male whereas 28/59 (47.5%) were female. Mean age of all patients was 15.47+7.26 days and mean weight was 2.94+0.63Kg. Temperature instability was present in 79.7%, Tachypnea in 69.5%, Tachycardia in 66.1%, delayed capillary refill in 64.4% and oliguria in 55.9%. Blood cultures were positive in 64.4% and raised CRP was found in 64.5%. Sensitivity, specificity, positive predictive value and negative predictive of raised CRP was found to be 97.3%, 95.2%, 97.3% and 95.2% respectively. In conclusion this study show that C-reactive protein has high sensitivity and specificity for establishing the diagnosis of neonatal sepsis which is comparable to that of blood culture results.

Study of C - reactive protein in neonatal sepsis

2017 ◽  
Vol 4 (3) ◽  
pp. 890
Author(s):  
Gunjan Mehrotra
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
The Body ◽  
Causative Organism ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Reactive Protein ◽  
Sensitivity Specificity

Background: Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. Neonatal sepsis in newborn is characterized by paucity of signs and symptoms and is due to invasion and spread through the body of non-pathogenic/ pathogenic & Gram positive / negative organism. It is subtle disease, the general characteristic of bacterial infection in neonatal period are influenced more by response of the infant than the causative organism. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP) for evaluation of neonatal sepsis in tertiary care hospital.Methods: Neonates with clinical suspicion of sepsis were prospectively studied out from June 2006 to January 2008. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS.Results: Of 50 neonates studied, 34 (68%) had positive CRP while 31 (62%) had positive blood culture. The sensitivity, specificity, positive and negative predictive values of CRP were 90.32%, 42.10%, 71.79% and 72.72% respectively.Conclusions: The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value.

scholarly journals The importance of early detection of endotoxemia

2016 ◽  
Vol 22 (7) ◽  
pp. 503-509 ◽  
Author(s):  
Barbara Adamik ◽  
Jakub Smiechowicz ◽  
Andrzej Kübler
Keyword(s):  
Septic Shock ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Clinical Challenge ◽  
Endotoxin Activity ◽  
Sepsis And Septic Shock ◽  
Clinical Conditions ◽  
Endotoxin Elimination ◽  
Selection Of Patients ◽  
Selection Of

Endotoxin is considered a key signaling molecule in the pathogenesis of sepsis and septic shock. Anti-endotoxin therapies may result in the improvement of a patient’s clinical condition and lower mortality. The pressing clinical challenge is to identify patients for whom endotoxin elimination would be the most beneficial. An endotoxin activity assay (EAA) has been available for detection of endotoxins, allowing selection of patients at high risk of endotoxemia in intensive care units (ICUs). We studied a cohort of 172 consecutive patients who had septic shock on admission to the ICU. Endotoxin activity (EA) was measured with a rapid chemiluminescent EAA, regarded as point-of-care testing. Endotoxemia with a mean EA of 0.59 ± 0.14 EAU was present in 104 patients (60%) and absent in 68 patients (EA = 0.25 ± 0.11 EAU). The risk of endotoxemia increased with the presence of a Gram-negative infection [odds ratio (OR) 3.1, 95% confidence interval (CI) 1.6–5.9; P = 0.001] and bacteremia (OR 3.8, 95% CI 1.6–8.9; P = 0.02) but did not change with a diagnosis of peritonitis (OR 1.03, 95% CI 0.54–1.97; P = 0.90). These findings indicate that anti-endotoxin interventions should be tailored to individual patients based on both clinical conditions and measured endotoxin levels.

scholarly journals 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

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

Sepsis and septic shock

2018 ◽  
pp. 161-168
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Septic Shock ◽  
Mortality Rate ◽  
Blood Culture ◽  
Antibiotic Therapy ◽  
Fluid Resuscitation ◽  
High Flow ◽  
Empirical Antibiotic Therapy ◽  
Goal Directed Therapy ◽  
Reduce Mortality Rate ◽  
Sepsis And Septic Shock

Sepsis is very common; however, goal–directed therapy significantly helps to reduce mortality rate following septic shock. Sepsis Six should be delivered within one hour of initial diagnosis of sepsis. The sepsis resuscitation and management bundle includes delivery of high flow O2, blood culture, measurement of lactate, empirical antibiotic therapy, and IV fluid resuscitation and renal support.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Usefulness of the heparin-binding protein level to diagnose sepsis and septic shock according to Sepsis-3 compared with procalcitonin and C reactive protein: a prospective cohort study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026527 ◽  
Author(s):  
Yixuan Zhou ◽  
Zhen Liu ◽  
Jun Huang ◽  
Guiling Li ◽  
Fengying Li ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Study ◽  
Roc Curve ◽  
Prospective Cohort ◽  
Heparin Binding ◽  
C Reactive Protein ◽  
Suspected Sepsis ◽  
Reactive Protein ◽  
Heparin Binding Protein ◽  
Sepsis And Septic Shock

ObjectivesOur aim was to assess the release level of heparin-binding protein (HBP) in sepsis and septic shock under theThird International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3).DesignProspective cohort study.SettingA general teaching hospital in China.ParticipantsAdult infected patients with suspected sepsis and people who underwent physical examination were included. According to the health status and severity of illness, the research subjects were divided into healthy, local infection, sepsis non-shock and septic shock under Sepsis-3 definitions.Main outcome measuresPlasma levels of HBP, procalcitonin (PCT), C reactive protein (CRP) and complete blood count were detected in all subjects. Single-factor analysis of variance was used to compare the biomarker levels of multiple groups. A receiver operating characteristic (ROC) curve was used to assess the diagnostic capacity of each marker.ResultsHBP levels were significantly higher in patients with sepsis non-shock than in those with local infections (median 49.7ng/mL vs 11.8 ng/mL, p<0.01) at enrolment. Moreover, HBP levels in patients with septic shock were significantly higher than in patients with sepsis without shock (median 153.8ng/mL vs 49.7 ng/mL, p<0.01). The area under the ROC curve (AUC) of HBP (cut-off ≥28.1 ng/mL) was 0.893 for sepsis which was higher than those of PCT (0.856) for a cut-off ≥2.05 ng/mL and of CRP (0.699) for a cut-off ≥151.9 mg/L. Moreover, AUC of HBP (cut-off ≥103.5 ng/mL) was 0.760 for septic shock which was higher than the ROC curve of sequential [sepsis-related] organ failure assessment (SOFA) Score (0.656) for a cut-off ≥5.5. However, there was no significant difference between 28-d survivors (n=56) and 28-d non-survivors (n=37) with sepsis in terms of HBP value (p=0.182).ConclusionsA high level of HBP in plasma is associated with sepsis, which might be a useful diagnostic marker in patients with suspected sepsis.

scholarly journals Procalcitonin, C-Reactive Protein, Albumin, and Blood Cultures as Early Markers of Sepsis Diagnosis or Predictors of Outcome: A Prospective Analysis

2019 ◽  
Vol 12 ◽  
pp. 2632010X1984767 ◽  
Author(s):  
Ana Cristina Schmidt de Oliveira-Netto ◽  
Luis G Morello ◽  
Libera M Dalla-Costa ◽  
Ricardo R Petterle ◽  
Rafael M Fontana ◽  
...  
Keyword(s):  
Septic Shock ◽  
Blood Culture ◽  
Albumin Level ◽  
Culture Collection ◽  
Apache Ii ◽  
Predictors Of Outcome ◽  
Aged Patients ◽  
Logistic Regression Models ◽  
Sepsis Diagnosis ◽  
Sepsis And Septic Shock

Purpose: Sepsis is a condition with high mortality rates and its diagnosis remains a challenge. We assessed epidemiological, clinical data, multiple biomarker profiles, and blood culture with respect to sepsis diagnosis and predictors of outcome. Methods: In total, 183 patients who were suspected of having sepsis and underwent blood culture collection were followed up for 7 days. Sepsis-related Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were calculated daily; biomarkers and blood culture test results were evaluated. Results: In total, 78 (43%) had sepsis, 50 (27%) had septic shock, and 55 (30%) had no sepsis. Blood culture was positive in 28% and 42% of the sepsis and septic shock groups, respectively ( P < .001). Regarding clinical profiles and biomarker values, there were no differences between the sepsis and non-sepsis groups, but significant differences were observed in the septic shock group. Multivariate logistic regression models revealed that age, serum albumin level, APACHE II, and SOFA 1st day scores were the independent variables for death. Conclusions: The challenge in the diagnosis of sepsis continues as clinical and laboratory differences found between the groups were due to septic shock. Older aged patients with lower albumin levels and higher APACHE II and SOFA 1st day scores have a greater probability of mortality.

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