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Lungu N, Popescu DE, Manea AM, Jura AMC, Doandes FM, Popa ZL, Gorun F, Citu C, Gruber D, Ciurescu S, Boia M. Hemoglobin, Ferritin, and Lactate Dehydrogenase as Predictive Markers for Neonatal Sepsis. J Pers Med 2024; 14:476. [PMID: 38793057 PMCID: PMC11122012 DOI: 10.3390/jpm14050476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: This study evaluates the predictive effectiveness of biomarkers in diagnosing newborn sepsis. (2) Methods: This was a case-control study conducted on neonates hospitalized at the Clinical Hospital "Louis Turcanu", Timisoara, Romania, from October 2018 to July 2023. Using a vacutainer collection device, venous blood was collected at admission for complete blood tests, including ferritin, hemoglobin, LDH, and blood culture analysis. Neonates were divided into two groups: sepsis-positive and sepsis-negative. The outcome of interest was a diagnosis of sepsis. (3) Results: Data from 86 neonates, 51 of whom had been confirmed to have sepsis, were analyzed. This study found no significant difference in gestational age, infant weight, fetal growth restriction, or APGAR score between neonates with and without sepsis. However, there was a higher incidence of sepsis among neonates delivered via cesarean section. Neonatal patients with sepsis showed significantly higher levels of neonatal serum ferritin and LDH compared to those without sepsis. Ferritin and LDH biomarkers demonstrated excellent discriminatory capabilities in diagnosing neonatal sepsis. Logistic regression analysis revealed a significant association between elevated ferritin and LDH levels and the likelihood of neonatal sepsis, while anemia did not show a significant association. (4) Conclusions: LDH and ferritin concentrations are found to be predictive biomarkers for neonatal sepsis, indicating a potential role in detecting susceptible neonates and implementing prompt interventions to improve patient outcomes.
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Affiliation(s)
- Nicoleta Lungu
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
| | - Daniela-Eugenia Popescu
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania (D.G.); (S.C.)
| | - Aniko Maria Manea
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
| | - Ana Maria Cristina Jura
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania (D.G.); (S.C.)
| | - Florina Marinela Doandes
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
| | - Zoran Laurentiu Popa
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
| | - Florin Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300172 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
| | - Denis Gruber
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania (D.G.); (S.C.)
| | - Sebastian Ciurescu
- Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania (D.G.); (S.C.)
| | - Marioara Boia
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (N.L.); (A.M.M.); (F.M.D.); (Z.L.P.); (C.C.); (M.B.)
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Surrati AM, Alharbi KM, Mohammedsaeed W, Almohammadi HF. Neonatal Group B Streptococcus infection at a single center in Al-Madinah Al-Munawarah, Saudi Arabia. Saudi Med J 2024; 45:163-170. [PMID: 38309734 PMCID: PMC11115410 DOI: 10.15537/smj.2024.45.2.20230533] [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: 07/16/2023] [Accepted: 12/11/2023] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To determine the occurrence of Group B Streptococcus (GBS) infection in neonates and its associated risk factors in Al-Madinah Al-Munawarah, Saudi Arabia. METHODS This retrospective study was carried out at the Maternity and Child Hospital in Al-Madinah Al-Munawarah, between 2017-2022. The laboratory and clinical data of 64 neonates were collected and analyzed using GraphPad Prism 7 software. RESULTS Out of 16,022 neonates admitted to the nursery, 64 infants were diagnosed with GBS infection. Approximately 53.1% were male, 46.9% female, 15.6% were preterm, and 84.4% were full-term. Vaginal births accounted for 71.9%. The mean onset age was 10±12.4 days. Among the GBS patients, 53.1% had early-onset disease (EOD, 0-6 days), while 46.9% had late-onset disease (LOD, 7-90 days). Unexamined mothers had a higher incidence of GBS and EOD newborns (p=0.05). Meningitis was more common in LOD than EOD patients and correlated with illness onset (p=0.05). Early-onset disease patients had a higher incidence of sepsis. The mortality rate was 10.9%, while 89.1% were discharged from the hospital. CONCLUSION Neonatal GBS infection is prevalent in Al-Madinah Al-Munawarah. Several risk factors may contribute to the occurrence of GBS infection including preterm labor, higher body temperature during delivery, prolonged premature rupture of membranes for more than 18 hours, and GBS bacteriuria. We recommend that larger multi-centric studies are needed in Al-Madinah Al-Munawarah, to study the magnitude of neonatal GBS infection and risk factors to develop a screening protocol in maternity and children's hospital.
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Affiliation(s)
- Amal M. Surrati
- From the Department of Family and Community Medicine and Medical Education (Surrati), College of Medicine, Taibah University; from the Department of Pediatrics (Alharbi), College of Medicine, Taibah University; from the Department of Clinical Laboratory Sciences (Mohammedsaeed), Faculty of Applied Medical Sciences, Taibah University, and from the Department of Neonatal Intensive Care Unit (Almohammadi), Maternity and Children Hospital, King Salman bin abdulaziz Medical City, Ministry of Health, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
| | - Khulood M. Alharbi
- From the Department of Family and Community Medicine and Medical Education (Surrati), College of Medicine, Taibah University; from the Department of Pediatrics (Alharbi), College of Medicine, Taibah University; from the Department of Clinical Laboratory Sciences (Mohammedsaeed), Faculty of Applied Medical Sciences, Taibah University, and from the Department of Neonatal Intensive Care Unit (Almohammadi), Maternity and Children Hospital, King Salman bin abdulaziz Medical City, Ministry of Health, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
| | - Walaa Mohammedsaeed
- From the Department of Family and Community Medicine and Medical Education (Surrati), College of Medicine, Taibah University; from the Department of Pediatrics (Alharbi), College of Medicine, Taibah University; from the Department of Clinical Laboratory Sciences (Mohammedsaeed), Faculty of Applied Medical Sciences, Taibah University, and from the Department of Neonatal Intensive Care Unit (Almohammadi), Maternity and Children Hospital, King Salman bin abdulaziz Medical City, Ministry of Health, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
| | - Hanaa F. Almohammadi
- From the Department of Family and Community Medicine and Medical Education (Surrati), College of Medicine, Taibah University; from the Department of Pediatrics (Alharbi), College of Medicine, Taibah University; from the Department of Clinical Laboratory Sciences (Mohammedsaeed), Faculty of Applied Medical Sciences, Taibah University, and from the Department of Neonatal Intensive Care Unit (Almohammadi), Maternity and Children Hospital, King Salman bin abdulaziz Medical City, Ministry of Health, Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia.
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Yeaman F, Stritzke A, Kuret V, Sharifi N, Seow CH, Metcalfe A, Leung Y. Thiopurine Exposure During Pregnancy is Not Associated With Anemia in Infants Born to Mothers With IBD. CROHN'S & COLITIS 360 2023; 5:otad066. [PMID: 37941596 PMCID: PMC10629965 DOI: 10.1093/crocol/otad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Indexed: 11/10/2023] Open
Abstract
Background Thiopurines are commonly used to treat inflammatory bowel disease (IBD). Thiopurines are considered safe throughout pregnancy. However, a published study suggested the risk of neonatal anemia was increased if exposed to thiopurines in utero. This prospective cohort study aimed to determine if there is an increased risk of cytopenia among infants born to pregnant people with IBD, exposed or unexposed to thiopurines, compared to infants born to those without IBD. Methods Pregnant IBD patients, with and without thiopurine exposure, and one cohort of control individuals were recruited over a 5-year period. Consenting individuals completed a questionnaire and infants had a complete blood cell count at the newborn heel prick. Anemia was defined as hemoglobin (Hb) < 140g/L. Descriptive statistics were used to characterize the study population. Fisher exact tests were used to examine differences in outcomes between groups, a P-value of < 0.05 was deemed significant. Results Three cohorts were recruited: 19 IBD patients on thiopurines, 50 IBD patients not on thiopurines, and 37 controls (total of 106). Neonatal median Hb was not different with 177g/L (IQR 38g/L) for the IBD thiopurine group, 180.5g/L (IQR 40g/L) for the IBD non-thiopurine group, and 181g/L (IQR 37g/L) for the controls. Nineteen infants (18%) were cytopenic with 12 (11%) anemic, 6 (5.6%) thrombocytopenic, and 1 (0.94%) lymphopenic. Thiopurine exposure was only in one, mildly anemic, infant. Conclusions These findings further support physicians and IBD patients contemplating pregnancy that current guidelines recommending thiopurine adherence do not lead to increased perinatal risk of anemia or cytopenia.
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Affiliation(s)
- Fiona Yeaman
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Internal Medicine, University of Western Australia, Perth, WA, Australia
| | - Amelie Stritzke
- Department of Pediatrics University of Calgary, Calgary, AB, Canada
| | - Verena Kuret
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
| | - Nastaran Sharifi
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cynthia H Seow
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences; University of Calgary, Calgary, AB, Canada
| | - Amy Metcalfe
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences; University of Calgary, Calgary, AB, Canada
| | - Yvette Leung
- Department of Medicine and Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
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Wang B, Wang QM, Li DX. An Analysis of Predictive Factors for Severe Neonatal Infection and the Construction of a Prediction Model. Infect Drug Resist 2023; 16:3561-3574. [PMID: 37305733 PMCID: PMC10256622 DOI: 10.2147/idr.s408126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Objective To investigate the primary predictive factors for the occurrence of severe neonatal infection, construct a prediction model and assess its effectiveness. Methods A total of 160 neonates hospitalised in the Department of Neonatology at Suixi County Hospital from January 2019 to June 2022 were retrospectively analysed. Clinical data was analyzed to determine the primary predictive factors for the occurrence of severe neonatal infection. Predictive efficacy was evaluated using a receiver operating characteristic curve, and a nomogram model was constructed according to the predictors. A bootstrap technique was used to verify the accuracy of the model. Results The neonates were divided, based on the degree of infection, into a mild infection group (n = 80) and a severe infection group (n = 80) according to a 1:1 ratio. Multivariate logistic regression analysis showed that compared with the recovery stage, white blood cell count (WBC) and platelet count (PLT) in the two groups were significantly decreased in the early stage of infection, and the ratio of mean platelet volume to PLT, as well as C-reactive protein (CRP) and procalcitonin levels, was elevated (P < 0.05). The area under the curves (AUCs) of decreased WBC, decreased PLT and elevated CRP levels, and the combination of these three indicators, were 0.881, 0.798, 0.523 and 0.914, respectively. According to the filtered indicators, two models (a dichotomous variable equation model and a nomogram model) of continuous numerical variables were constructed, and their AUCs were 0.958 and 0.914, respectively. The calibration curve of the nomogram model was validated with a consistency index of 0.908 (95% confidence interval [0.862, 0.954]). Conclusion Decreased WBC and PLT levels and an elevated CRP level were the primary independent predictors of severe neonatal infection.
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Affiliation(s)
- Bo Wang
- Department of Neonatology, The Hospital of Suixi County, Huaibei, People’s Republic of China
| | - Qi-Mao Wang
- Department of Neonatology, The Hospital of Suixi County, Huaibei, People’s Republic of China
| | - De-Xin Li
- Department of Neonatology, The Hospital of Suixi County, Huaibei, People’s Republic of China
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Vizcarra-Jiménez D, Copaja-Corzo C, Hueda-Zavaleta M, Parihuana-Travezaño EG, Gutierrez-Flores M, Rivarola-Hidalgo M, Benites-Zapata VA. Predictors of Death in Patients with Neonatal Sepsis in a Peruvian Hospital. Trop Med Infect Dis 2022; 7:tropicalmed7110342. [PMID: 36355884 PMCID: PMC9697646 DOI: 10.3390/tropicalmed7110342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Reducing neonatal mortality is a global challenge. This study’s objective was to determine the predictors of mortality in patients with neonatal sepsis. The study was a retrospective cohort study in a Peruvian hospital from January 2014 to April 2022. Neonates diagnosed with sepsis were included. To find predictors of mortality, we used Cox proportional regression models. We evaluated 288 neonates with sepsis; the median birth weight and hospitalization time were 3270 g and seven days, respectively. During follow-up, 18.4% did not survive, and the most common complications were jaundice (35.42%), respiratory distress syndrome (29.51%), and septic shock (12.5%). The most isolated bacteria were Klebsiella pneumoniae. The risk factors associated with higher mortality were prematurity (aHR = 13.92; 95% CI: 1.71−113.51), platelets <150,000 (aHR = 3.64; 1.22−10.88), creatinine greater than 1.10 (aHR = 3.03; 1.09−8.45), septic shock (aHR = 4.41; 2.23−8.74), and admission to IMV (aHR = 5.61; 1.86−16.88), On the other hand, breastfeeding was associated with a lower risk of death (aHR = 0.25; 0.13−0.48). In conclusion, we report a high incidence of death and identify clinical (prematurity, septic shock, admission to IMV) and laboratory characteristics (elevated creatinine and thrombocytopenia) associated with higher mortality in patients with neonatal sepsis. Breastfeeding was a factor associated with survival in these patients.
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Affiliation(s)
| | - Cesar Copaja-Corzo
- Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna 23003, Peru
- Red Asistencial Ucayali EsSalud, Ucayali 25003, Peru
- Correspondence: (C.C.-C.); (V.A.B.-Z.)
| | - Miguel Hueda-Zavaleta
- Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna 23003, Peru
- Hospital III Daniel Alcides Carrion EsSalud, Tacna 23000, Peru
| | | | - Maykel Gutierrez-Flores
- Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna 23003, Peru
- Hospital Hipólito Unanue de Tacna, Tacna 23003, Peru
| | | | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Correspondence: (C.C.-C.); (V.A.B.-Z.)
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