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van Leeuwen LM, Fourie E, van den Brink G, Bekker V, van Houten MA. Diagnostic value of maternal, cord blood and neonatal biomarkers for early-onset sepsis: a systematic review and meta-analysis. Clin Microbiol Infect 2024; 30:850-857. [PMID: 38467246 DOI: 10.1016/j.cmi.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND An accurate diagnosis of early-onset sepsis (EOS) is challenging because of subtle symptoms and the lack of a good diagnostic tool, resulting in considerable antibiotic overtreatment. A biomarker, discriminating between infected and non-infected newborns at an early stage of the disease, could improve EOS prediction. Numerous biomarkers have been tested, but have never been compared directly. OBJECTIVES We aimed to provide a comprehensive overview of early biomarkers and their diagnostic value in maternal samples, umbilical cord blood, and neonatal serum. DATA SOURCES PubMed-Medline, EMBASE, The Cochrane Library, and Web of Science were searched up to 1 March 2023, without restrictions on publication date, population, or language. STUDY ELIGIBILITY CRITERIA Articles describing the diagnostic value of at least one biomarker in the detection of EOS in neonates, independent of gestational age, were included. ASSESSMENT OF RISK OF BIAS The QUADAS-2 tool was used to assess study quality. METHODS OF DATA SYNTHESIS Three independent researchers assessed the articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was performed with all manuscripts describing diagnostic accuracy using a random-effects model. RESULTS Of 2296 identified articles, 171 reports were included in the systematic review and 69 in the meta-analysis. Literature showed mixed and inconsistent evidence for most biomarkers and sample types, because of a lack of a uniform EOS case definition, small sample sizes, and large heterogeneity between studies. Interesting markers were procalcitonin (pooled sensitivity 79%, 95% CI 71-84%; specificity 91%, 95% CI 83-96%, n = 11) and interleukin (IL)-6 (pooled sensitivity 83%, 95% CI 71-90%; specificity 87%, 95% CI 78-93%, n = 8) in umbilical cord blood and presepsin (pooled sensitivity 82%, 95% CI 62-93%; specificity 86%, 95% CI 73-93%, n = 3) and serum amyloid A (pooled sensitivity 92%, 95% CI 75-98%; specificity 96%, 95% CI 78-99%, n = 4) in neonatal serum. Studies on the combination of biomarkers were scarce. CONCLUSIONS A biomarker stand-alone test is currently not reliable for direct antibiotic stewardship in newborns, although several biomarkers show promising initial results. Further research into biomarker combinations could lead to an improved EOS diagnosis, reduce antibiotic overtreatment, and prevent associated health-related problems.
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Affiliation(s)
- Lisanne M van Leeuwen
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands; Willem-Alexander Children's Hospital, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Elandri Fourie
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands
| | - Gerrie van den Brink
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands
| | - Vincent Bekker
- Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands
| | - Marlies A van Houten
- Department of Paediatrics and of Vaccine, Infection and Immunology, Spaarne Gasthuis Hospital, Haarlem, the Netherlands.
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俞 元, 陈 平. [Advances in clinical management of neonatal sepsis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:518-522. [PMID: 38802914 PMCID: PMC11135065 DOI: 10.7499/j.issn.1008-8830.2309145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/19/2024] [Indexed: 05/29/2024]
Abstract
Neonatal sepsis, as a significant cause of various complications and adverse outcomes in neonates, remains a serious health burden both domestically and internationally. Strategies such as antibiotic prophylaxis during delivery, the utilization of early-onset sepsis risk calculators, and quality improvement initiatives in neonatal wards are beneficial in alleviating the disease burden of neonatal sepsis. This paper provides a review of the epidemiology, risk factors, and recent advances in clinical management of neonatal sepsis.
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Neal SR, Fitzgerald F, Chimhuya S, Heys M, Cortina-Borja M, Chimhini G. Diagnosing early-onset neonatal sepsis in low-resource settings: development of a multivariable prediction model. Arch Dis Child 2023; 108:608-615. [PMID: 37105710 PMCID: PMC10423484 DOI: 10.1136/archdischild-2022-325158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/26/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To develop a clinical prediction model to diagnose neonatal sepsis in low-resource settings. DESIGN Secondary analysis of data collected by the Neotree digital health system from 1 February 2019 to 31 March 2020. We used multivariable logistic regression with candidate predictors identified from expert opinion and literature review. Missing data were imputed using multivariate imputation and model performance was evaluated in the derivation cohort. SETTING A tertiary neonatal unit at Sally Mugabe Central Hospital, Zimbabwe. PATIENTS We included 2628 neonates aged <72 hours, gestation ≥32+0 weeks and birth weight ≥1500 g. INTERVENTIONS Participants received standard care as no specific interventions were dictated by the study protocol. MAIN OUTCOME MEASURES Clinical early-onset neonatal sepsis (within the first 72 hours of life), defined by the treating consultant neonatologist. RESULTS Clinical early-onset sepsis was diagnosed in 297 neonates (11%). The optimal model included eight predictors: maternal fever, offensive liquor, prolonged rupture of membranes, neonatal temperature, respiratory rate, activity, chest retractions and grunting. Receiver operating characteristic analysis gave an area under the curve of 0.74 (95% CI 0.70-0.77). For a sensitivity of 95% (92%-97%), corresponding specificity was 11% (10%-13%), positive predictive value 12% (11%-13%), negative predictive value 95% (92%-97%), positive likelihood ratio 1.1 (95% CI 1.0-1.1) and negative likelihood ratio 0.4 (95% CI 0.3-0.6). CONCLUSIONS Our clinical prediction model achieved high sensitivity with low specificity, suggesting it may be suited to excluding early-onset sepsis. Future work will validate and update this model before considering implementation within the Neotree.
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Affiliation(s)
- Samuel R Neal
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Felicity Fitzgerald
- Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Simba Chimhuya
- Child and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Michelle Heys
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
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Snoek L, van Kassel MN, Krommenhoek JF, Achten NB, Plötz FB, van Sorge NM, Brouwer MC, van de Beek D, Bijlsma MW. Neonatal early-onset infections: Comparing the sensitivity of the neonatal early-onset sepsis calculator to the Dutch and the updated NICE guidelines in an observational cohort of culture-positive cases. EClinicalMedicine 2022; 44:101270. [PMID: 35059618 PMCID: PMC8760457 DOI: 10.1016/j.eclinm.2021.101270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The early-onset sepsis calculator (EOSC) reduces unnecessary antibiotic treatment in newborns. However, its performance in identifying cases with early-onset disease (EOD) is unclear. We compared the sensitivity of the EOSC to the current Dutch and National Institute for Health and Care Excellence (NICE) guidelines when applied to a cohort of newborns with culture-positive early-onset sepsis and meningitis. METHODS Culture-positive Streptococcus agalactiae (GBS) and Escherichia coli (E. coli) sepsis and meningitis patients ≤3 days old with a gestational age ≥34 weeks, identified between 1/1/2018 and 31/1/2021 in a Dutch prospective nationwide cohort study were included. Cases were identified by treating physicians and microbiological surveillance. Primary outcome was the proportion of patients that would have been treated according to the EOSC, the Dutch, and the NICE EOD prevention guidelines. Differences between proportions were analysed using McNemar's test. FINDINGS We included 81 GBS and 7 E. coli EOD cases. At 4 h after birth, the EOSC would have recommended antibiotic treatment in 32 (36%) patients, compared to 44 (50%) by the Dutch (p<0·01) and 48 (55%) by the NICE guideline (p<0·01). The EOSC would have initially recommended routine care for 52% of patients compared to 31% and 30% for the Dutch and NICE guidelines (p<0·01). At 24 h after birth, the EOSC would have recommended antibiotic treatment in 54 (61%) infants compared to 64 (73%) by the Dutch (p = 0·02) and 63 (72%) by the NICE guidelines (p = 0·06). INTERPRETATION The sensitivity of the EOSC in identifying cases of EOD is lower compared to both Dutch and NICE guidelines, especially directly after birth. The EOSC relies more on clinical symptoms and results in less overtreatment of healthy newborns at the cost of later antibiotic treatment in initially well-appearing EOD patients. FUNDING This work was supported by grants received from Netherlands Organization for Health Research and Development (ZonMw; NWO-Vidi-Grant (grant number 917·17·308); NWO-Vici-Grant (grant number 918·19·627)), the Academic Medical Centre (AMC Innovative Impulse Grant) and Steun Emma Foundation Grant.
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Affiliation(s)
- Linde Snoek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Merel N. van Kassel
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Jurjen F. Krommenhoek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Niek B. Achten
- Department of Paediatrics, Tergooi Hospital, Rijksstraatweg 1, 1261 AN Blaricum, the Netherlands
- Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Frans B. Plötz
- Department of Paediatrics, Tergooi Hospital, Rijksstraatweg 1, 1261 AN Blaricum, the Netherlands
- Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Nina M. van Sorge
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Matthijs C. Brouwer
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Diederik van de Beek
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - Merijn W. Bijlsma
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
- Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
| | - NOGBS study group1
- Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
- Department of Paediatrics, Tergooi Hospital, Rijksstraatweg 1, 1261 AN Blaricum, the Netherlands
- Department of Paediatrics, Emma Children's Hospital, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
- Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
- Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, the Netherlands
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Yu Y, Dong Q, Li S, Qi H, Tan X, Ouyang H, Hu J, Li W, Wang T, Yang Y, Gong X, He X, Chen P. Etiology and clinical characteristics of neonatal sepsis in different medical setting models: A retrospective multi-center study. Front Pediatr 2022; 10:1004750. [PMID: 36275054 PMCID: PMC9581286 DOI: 10.3389/fped.2022.1004750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE General hospitals admit lower gestational age neonates than maternal and child health care centers, therefore associated with a higher morbidity and mortality. This study aimed to assess the etiology and clinical characteristics of neonatal sepsis in different medical setting models. METHODS Neonates admitted to 5 tertiary medical centers, including one national general hospital, two maternal and child health care hospitals and two regional general hospitals, in central-south China with culture-proven sepsis between January 2010 and December 2019 were included in the study. We compared maternal and neonatal characteristics, pathogen distribution, treatment and neonatal outcomes among 3 different medical setting models in this retrospective cohort. RESULTS We identified 757 episodes of culture-proven sepsis in 757 neonates. The predominant pathogens were coagulase-negative staphylococci, Klebsiella pneumoniae, Escherichia coli and Group B streptococci. A total of 683 neonates with detailed information were involved in further comparison; 54.6% were from the national general hospital, 35.9% were from the maternal and child health care hospital, and 9.5% were from the regional general hospital. Neonates in national and regional general hospitals had significantly lower gestational age and birthweight (P < 0.001). Patterns of pathogen distribution were different among these medical setting models. Early-onset sepsis was more common in maternal and child health care hospitals (61.4% vs. 42.1% vs. 46.7%, P < 0.001), while hospital-acquired late-onset sepsis was more common in national and regional general hospitals (32.7% vs. 33.3% vs. 11.4%, P < 0.001). The proportion of complications or comorbidities of neonates in maternal and child health care hospitals were significantly lower than neonates in national and regional general hospitals (P < 0.001). The case fatality rate was significantly higher in regional general hospitals (10.8% vs. 3.2% vs. 0.8%, P = 0.001). CONCLUSION We report distinct patterns of clinical characteristics, pathogens and outcomes in patient subgroups with neonatal sepsis from national general hospital, maternal and child health care hospital and regional general hospital. It might have some implications for improvement of prevention, management and empirical antibiotic use in neonatal sepsis in different setting models, especially in resource-limited settings from middle and low-income countries.
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Affiliation(s)
- Yuanqiang Yu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, China
| | - Qingyi Dong
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Suping Li
- Department of Neonatology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Huaxue Qi
- Department of Neonatology, Changsha Hospital for Maternal / Child Health Care, Changsha, China
| | - Xin Tan
- Department of Pediatrics, The First Hospital of Changsha, Changsha, China
| | - Hong Ouyang
- Department of Neonatology, Xiangtan Central Hospital, Xiangtan, China
| | - Jintao Hu
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen Li
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao Wang
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yonghui Yang
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyun Gong
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaori He
- Department of Neonatology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Pingyang Chen
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, China
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Cussen A, Guinness L. Cost savings from use of a neonatal sepsis calculator in Australia: A modelled economic analysis. J Paediatr Child Health 2021; 57:1037-1043. [PMID: 33592674 DOI: 10.1111/jpc.15384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 01/25/2023]
Abstract
AIM To estimate the change in average cost and length of stay (LOS) for the neonatal birth admission resulting from use of the neonatal early-onset sepsis (EOS) calculator compared to guideline-based management, in an Australian perinatal health-care setting. METHODS A decision-analytic model (decision tree) was constructed to assess admission cost and LOS with EOS calculator use compared to guideline-based management. Probabilities of clinical sepsis-related outcomes were obtained via review of published literature. Costs and average LOS were obtained from Australia's Independent Hospital Pricing Authority. RESULTS EOS calculator use was associated with a reduction in costs of AUD$25806 and in average LOS of 25.4 days per 1000 babies born. Sensitivity analyses demonstrated greater net benefits could be expected for services where there is a higher baseline rate of antibiotic use. CONCLUSION This model demonstrates a significant cost reduction for the neonatal birth admission, associated with use of the EOS calculator as compared to existing guidelines. The net benefit may be greater in Australia, where rates of empiric antibiotic use are reportedly high, compared to some European countries and the United States. Future research opportunities include prospective collection of economic data alongside the introduction of the EOS calculator.
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Affiliation(s)
- Alexandra Cussen
- Department of Paediatrics, Austin Health, Heidelberg, Victoria, Australia
| | - Lorna Guinness
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Rao L, Song Z, Yu X, Tu Q, He Y, Luo Y, Yin Y, Chen D. Progranulin as a novel biomarker in diagnosis of early-onset neonatal sepsis. Cytokine 2020; 128:155000. [PMID: 31982701 DOI: 10.1016/j.cyto.2020.155000] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Infections are leading causes of morbidity and mortality in neonates and may also have severe long-term consequences. As early diagnosis of neonatal sepsis improves prognosis, identification of new or complementary biomarkers is of great importance. In this study, we have evaluated the diagnostic value of progranulin (PGRN) in early-onset neonatal sepsis (EOS) and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP). METHODS A total of 121 infants with gestational age of >34 weeks admitted with suspected EOS were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT and PGRN were obtained from all neonates. Receiver-operating characteristic (ROC) curve and multivariate logistic regression analyses were performed. RESULTS Serum PGRN level of infected group was significantly higher than uninfected group (median 47.72 vs. 37.86 ng/ml, respectively; Mann-Whitney p < 0.0001). The ROC area under the curve (AUC) was 0.786 [95% confidence interval (CI) 0.706-0.867; p < 0.0001] for PGRN, 0.699 (95% CI 0.601-0.797; p = 0.0001) for age adjusted PCT, and 0.673 (95% CI 0.573-0.773; p = 0.0007) for CRP. With a cut-off value of 37.89 ng/ml, the diagnostic sensitivity and negative predictive value of PGRN were 94.34% and 91.7%, respectively. PGRN could significantly predict EOS independently of PCT (p < 0.0001), and the combined use of PGRN and PCT could significantly improve diagnostic performance for EOS (0.806; 95% CI 0.73-0.88; p < 0.0001), with a specificity of 89.06% and a positive predictive value of 81.10%. CONCLUSIONS PGRN may be used as a promising biomarker for the diagnosis of EOS, and the combined use of PGRN and PCT could improve the diagnosis of sepsis.
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Affiliation(s)
- Lubei Rao
- Department of Clinical Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Chongqing Key Laboratory of Pediatrics. Chongqing, China.
| | - Zhixin Song
- Department of Clinical Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Chongqing Key Laboratory of Pediatrics. Chongqing, China.
| | - Xiaoyan Yu
- Department of Clinical Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Chongqing Key Laboratory of Pediatrics. Chongqing, China
| | - Qianqian Tu
- Department of Clinical Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Chongqing Key Laboratory of Pediatrics. Chongqing, China
| | - Yu He
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Department of Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yibing Yin
- Key Laboratory of Diagnostic Medicine designated by the Ministry of Education, Chongqing Medical University, Chongqing, China
| | - Dapeng Chen
- Department of Clinical Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Chongqing Key Laboratory of Pediatrics. Chongqing, China.
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Yu JL. [Accurate use of antibiotics for preterm infants with early-onset sepsis should be taken seriously]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:7-8. [PMID: 31948516 PMCID: PMC7389717 DOI: 10.7499/j.issn.1008-8830.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 06/10/2023]
Abstract
At present, non-standard use of antibiotics remains a common phenomenon in the treatment of preterm infants with early-onset sepsis (EOS) in China. The expert panel of neonatologists in Hunan Province formulated a consensus on the diagnosis and use of antibiotics for EOS in preterm infant [Chin J Contemp Pediatr, 2020, 22(1): 1-6], which has a positive effect on the rational use of antibiotics. Based on this consensus, this article points out that in order to use antibiotics accurately, it is necessary to accurately identify EOS in preterm infants, accurately understand their clinical manifestations and medical history, and accurately evaluate the laboratory test results. Also, this article offers suggestions for the use of antibiotics in preterm infants with EOS.
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Affiliation(s)
- Jia-Lin Yu
- Shenzhen University General Hospital, Shenzhen, Guangdong 518055, China. yujialin
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