Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers
This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk fa...
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| Published in: | Frontiers in pediatrics Vol. 10; p. 840288 |
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| Format: | Journal Article |
| Language: | English |
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08.03.2022
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| ISSN: | 2296-2360, 2296-2360 |
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| Abstract | This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk factors influence the results of inflammatory markers as do gestational age, the time of sampling, the use of either cord blood or neonatal peripheral blood, and some non-infectious causes. Current evidence suggests that the use of promising diagnostic markers such as CD11b, CD64, IL-6, IL-8, PCT, and CRP, either alone or in combination, might enable clinicians discontinuing antibiotics confidently within 24–48 h. However, none of the current diagnostic markers is sensitive and specific enough to support the decision of withholding antibiotic treatment without considering clinical findings. It therefore seems to be justified that antibiotics are often initiated in ill term and especially preterm infants. Early markers like IL-6 and later markers like CRP are helpful in the diagnosis of neonatal sepsis considering the clinical aspect of the neonate, the gestational age, maternal risk factors and the time (age of the neonate regarding early-onset sepsis) of blood sampling. |
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| AbstractList | This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk factors influence the results of inflammatory markers as do gestational age, the time of sampling, the use of either cord blood or neonatal peripheral blood, and some non-infectious causes. Current evidence suggests that the use of promising diagnostic markers such as CD11b, CD64, IL-6, IL-8, PCT, and CRP, either alone or in combination, might enable clinicians discontinuing antibiotics confidently within 24-48 h. However, none of the current diagnostic markers is sensitive and specific enough to support the decision of withholding antibiotic treatment without considering clinical findings. It therefore seems to be justified that antibiotics are often initiated in ill term and especially preterm infants. Early markers like IL-6 and later markers like CRP are helpful in the diagnosis of neonatal sepsis considering the clinical aspect of the neonate, the gestational age, maternal risk factors and the time (age of the neonate regarding early-onset sepsis) of blood sampling.This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk factors influence the results of inflammatory markers as do gestational age, the time of sampling, the use of either cord blood or neonatal peripheral blood, and some non-infectious causes. Current evidence suggests that the use of promising diagnostic markers such as CD11b, CD64, IL-6, IL-8, PCT, and CRP, either alone or in combination, might enable clinicians discontinuing antibiotics confidently within 24-48 h. However, none of the current diagnostic markers is sensitive and specific enough to support the decision of withholding antibiotic treatment without considering clinical findings. It therefore seems to be justified that antibiotics are often initiated in ill term and especially preterm infants. Early markers like IL-6 and later markers like CRP are helpful in the diagnosis of neonatal sepsis considering the clinical aspect of the neonate, the gestational age, maternal risk factors and the time (age of the neonate regarding early-onset sepsis) of blood sampling. This is a narrative review on the role of biomarkers in the diagnosis of neonatal sepsis. We describe the difficulties to obtain standardized definitions in neonatal sepsis and discuss the limitations of published evidence of cut-off values and their sensitivities and specificities. Maternal risk factors influence the results of inflammatory markers as do gestational age, the time of sampling, the use of either cord blood or neonatal peripheral blood, and some non-infectious causes. Current evidence suggests that the use of promising diagnostic markers such as CD11b, CD64, IL-6, IL-8, PCT, and CRP, either alone or in combination, might enable clinicians discontinuing antibiotics confidently within 24-48 h. However, none of the current diagnostic markers is sensitive and specific enough to support the decision of withholding antibiotic treatment without considering clinical findings. It therefore seems to be justified that antibiotics are often initiated in ill term and especially preterm infants. Early markers like IL-6 and later markers like CRP are helpful in the diagnosis of neonatal sepsis considering the clinical aspect of the neonate, the gestational age, maternal risk factors and the time (age of the neonate regarding early-onset sepsis) of blood sampling. |
| Author | Resch, Bernhard Resch, Elisabeth Eichberger, Julia |
| AuthorAffiliation | 1 Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria 2 Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria |
| AuthorAffiliation_xml | – name: 1 Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz , Graz , Austria – name: 2 Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria |
| Author_xml | – sequence: 1 givenname: Julia surname: Eichberger fullname: Eichberger, Julia – sequence: 2 givenname: Elisabeth surname: Resch fullname: Resch, Elisabeth – sequence: 3 givenname: Bernhard surname: Resch fullname: Resch, Bernhard |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35345614$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright © 2022 Eichberger, Resch and Resch. Copyright © 2022 Eichberger, Resch and Resch. 2022 Eichberger, Resch and Resch |
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| Keywords | late onset sepsis C-reactive protein (CRP) early onset sepsis inflammatory marker preterm/full term infants interleukin-6 |
| Language | English |
| License | Copyright © 2022 Eichberger, Resch and Resch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 Edited by: Arjan Te Pas, Leiden University, Netherlands Reviewed by: Rob Taal, Erasmus MC-Sophia Children's Hospital, Netherlands; Claus Klingenberg, UiT the Arctic University of Norway, Norway This article was submitted to Neonatology, a section of the journal Frontiers in Pediatrics |
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| Title | Diagnosis of Neonatal Sepsis: The Role of Inflammatory Markers |
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