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Zhu B, Zhou R, Qin J, Li Y. Hierarchical Capability in Distinguishing Severities of Sepsis via Serum Lactate: A Network Meta-Analysis. Biomedicines 2024; 12:447. [PMID: 38398049 PMCID: PMC10886935 DOI: 10.3390/biomedicines12020447] [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: 01/15/2024] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Blood lactate is a potentially useful biomarker to predict the mortality and severity of sepsis. The purpose of this study is to systematically review the ability of lactate to predict hierarchical sepsis clinical outcomes and distinguish sepsis, severe sepsis and septic shock. Methods: We conducted an exhaustive search of the PubMed, Embase and Cochrane Library databases for studies published before 1 October 2022. Inclusion criteria mandated the presence of case-control, cohort studies and randomized controlled trials that established the association between before-treatment blood lactate levels and the mortality of individuals with sepsis, severe sepsis or septic shock. Data was analyzed using STATA Version 16.0. Results: A total of 127 studies, encompassing 107,445 patients, were ultimately incorporated into our analysis. Meta-analysis of blood lactate levels at varying thresholds revealed a statistically significant elevation in blood lactate levels predicting mortality (OR = 1.57, 95% CI 1.48-1.65, I2 = 92.8%, p < 0.00001). Blood lactate levels were significantly higher in non-survivors compared to survivors in sepsis patients (SMD = 0.77, 95% CI 0.74-0.79, I2 = 83.7%, p = 0.000). The prognostic utility of blood lactate in sepsis mortality was validated through hierarchical summary receiver operating characteristic curve (HSROC) analysis, yielding an area under the curve (AUC) of 0.72 (95% CI 0.68-0.76), accompanied by a summary sensitivity of 0.65 (95% CI 0.59-0.7) and a summary specificity of 0.7 (95% CI 0.64-0.75). Unfortunately, the network meta-analysis could not identify any significant differences in average blood lactate values' assessments among sepsis, severe sepsis and septic shock patients. Conclusions: This meta-analysis demonstrated that high-level blood lactate was associated with a higher risk of sepsis mortality. Lactate has a relatively accurate predictive ability for the mortality risk of sepsis. However, the network analysis found that the levels of blood lactate were not effective in distinguishing between patients with sepsis, severe sepsis and septic shock.
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Affiliation(s)
| | | | | | - Yifei Li
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu 610041, China; (B.Z.); (R.Z.); (J.Q.)
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Yilmaz A, Kaya N, Gonen I, Uygur A, Perk Y, Vural M. Evaluating of neonatal early onset sepsis through lactate and base excess monitoring. Sci Rep 2023; 13:14837. [PMID: 37684308 PMCID: PMC10491792 DOI: 10.1038/s41598-023-41776-0] [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: 05/06/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial blood gas and the 6th hour of life venous blood gas analysis on clinical sepsis in newborns. This is a cohort case-control study. In this study, 104 cases were divided into clinical and suspected sepsis groups according to the evaluation at the 24th hour after delivery. Lactate and BE values were evaluated in the cord arterial blood gas analysis (ABGA) and at the postnatal 6th-hour venous blood gas. The cord ABGA and postnatal 6th-hour results were compared in the clinical and suspected sepsis groups. Clinical sepsis was found to be associated with a lactate value above 2 mMol/L at postnatal 6th-hour venous blood gas (p = 0.041). This association was the highest when the clinical sepsis group's postnatal 6th-hour lactate cut-off value was determined as 3.38 mMol/L (sensitivity 57.9% and specificity 68.5%) (p = 0.032). However, no association was found between clinical sepsis diagnosis and venous BE's value in cord ABGA at the postnatal 6th hour. We found that a venous lactate value above 3.38 mMol/L at the postnatal 6th hour was the cut-off value that could indicate early-onset clinical sepsis. However, none of the biomarkers used in diagnosing EOS can accurately show all cases.
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Affiliation(s)
- Aslan Yilmaz
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Kocamustafapasa, Fatih, Istanbul, Turkey.
| | - Nesrin Kaya
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Kocamustafapasa, Fatih, Istanbul, Turkey
| | - Ilker Gonen
- Department of Neonatology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Abdulkerim Uygur
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Kocamustafapasa, Fatih, Istanbul, Turkey
| | - Yildiz Perk
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Kocamustafapasa, Fatih, Istanbul, Turkey
| | - Mehmet Vural
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34098, Kocamustafapasa, Fatih, Istanbul, Turkey
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Cai N, Liao W, Chen Z, Tao M, Chen S. The Mean Platelet Volume Combined with Procalcitonin as an Early Accessible Marker Helps to Predict the Severity of Necrotizing Enterocolitis in Preterm Infants. Int J Gen Med 2022; 15:3789-3795. [PMID: 35422655 PMCID: PMC9004728 DOI: 10.2147/ijgm.s346665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Na Cai
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, 400038, People’s Republic of China
| | - Wei Liao
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, 400038, People’s Republic of China
| | - Zhiqiang Chen
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, 400038, People’s Republic of China
| | - Min Tao
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, 400038, People’s Republic of China
- Correspondence: Min Tao; Sheng Chen, Department of Pediatrics, The First Hospital Affiliated to Army Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, People’s Republic of China, Tel +86-23-68766215; +86-23-68766213, Email ;
| | - Sheng Chen
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, 400038, People’s Republic of China
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Sun D, Wang Q, Zhang X, Zhao X, Zhang H, Liu A. Clinical Application of Serum Inflammatory Factors Combined with Dynamic Detection in the Diagnosis and Treatment of Neonatal Sepsis. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:325-332. [PMID: 33747996 PMCID: PMC7956080 DOI: 10.18502/ijph.v50i2.5347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: To investigate the clinical application value of the combination of the inflammatory factors and dynamic detection in the diagnosis and treatment of neonatal sepsis by detecting serum inflammatory factor C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) levels before and after treatment of neonatal infection. Methods: A total of 138 neonates with different degrees of infection were randomly enrolled, including 88 cases in the sepsis group and 50 cases in the virus infection group. Another 50 non-infected newborns in the same period were enrolled as the normal control group. Venous blood of all subjects for CRP, PCT, IL-6 detection, and send bacterial blood culture for sepsis and virus infection groups were collected at the same time. In the recovery period, venous blood of children in sepsis group was collected again to review CRP, PCT, IL-6, and differences in each test index of each group were compared. Results: The serum CRP, PCT, IL-6 levels in the sepsis group were significantly higher than those in the virus infection group (all P <0.05); serum CRP, PCT, IL-6 levels in the sepsis group were significantly lower than before treatment (P <0.05); the sensitivity and accuracy of the combined detection of indicators for the diagnosis of neonatal sepsis were significantly improved. Conclusion: The inflammatory factors CRP, PCT, and IL-6 are closely related to the occurrence and development of neonatal sepsis. Combined detection can effectively improve the diagnostic accordance rate, which is beneficial to the early diagnosis and early clinical intervention of neonatal sepsis.
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Affiliation(s)
- Dahong Sun
- Department of Pediatrics, The Third People's Hospital of Qingdao, Qingdao266041, China
| | - Qing Wang
- Department of Imaging, The People's Hospital of Zhangqiu Area, Jinan250200, China
| | - Xiaoyan Zhang
- Picu, Qingdao Women and Children's Hospital, Qingdao266000, China
| | - Xiuzhen Zhao
- Department of Pediatrics, The People's Hospital of Zhangqiu Area, Jinan250200, China
| | - Haiyan Zhang
- Department of Pediatrics, The People's Hospital of Zhangqiu Area, Jinan250200, China
| | - Aimei Liu
- Outpatient Department, Weifang People's Hospital, Weifang 261041, China
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Liu XP, Huang YS, Kuo HC, Xia HB, Yi-Sun, Huang WD, Lang XL, Liu CY, Liu X. A novel nomogram model for differentiating Kawasaki disease from sepsis. Sci Rep 2020; 10:13745. [PMID: 32792679 PMCID: PMC7427092 DOI: 10.1038/s41598-020-70717-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 03/16/2020] [Indexed: 02/07/2023] Open
Abstract
Kawasaki disease (KD) is a form of systemic vasculitis that occurs in children under the age of 5 years old. Due to prolonged fever and elevated inflammatory markers that are found in both KD and sepsis, the treatment approach differs for each. We enrolled a total of 420 children (227 KD and 193 sepsis) in this study. Logistic regression and a nomogram model were used to analyze the laboratory markers. We randomly selected 247 children as the training modeling group and 173 as the validation group. After completing a logistic regression analysis, white blood cell (WBC), anemia, procalcitonin (PCT), C-reactive protein (CRP), albumin, and alanine transaminase (ALT) demonstrated a significant difference in differentiating KD from sepsis. The patients were scored according to the nomogram, and patients with scores greater than 175 were placed in the high-risk KD group. The area under the curve of the receiver operating characteristic curve (ROC curve) of the modeling group was 0.873, sensitivity was 0.893, and specificity was 0.746, and the ROC curve in the validation group was 0.831, sensitivity was 0.709, and specificity was 0.795. A novel nomogram prediction model may help clinicians differentiate KD from sepsis with high accuracy.
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Affiliation(s)
- Xiao-Ping Liu
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Yi-Shuang Huang
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Ho-Chang Kuo
- Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, #123, Dapei Rd., Niaosong, Kaohsiung, 83301, Taiwan
| | - Han-Bing Xia
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Yi-Sun
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Wei-Dong Huang
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Xin-Ling Lang
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China
| | - Chun-Yi Liu
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China.
| | - Xi Liu
- The Department of Emergency and Pediatrics, Shenzhen Baoan Women's and Children's Hospital, Jinan University, #56, Yulv St., Baoan District, Shenzhen, 518102, Guangdong, China.
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El-Mekkawy MS, Ellahony DM, Khalifa KAE, Abd Elsattar ES. Plasma lactate can improve the accuracy of the Pediatric Sequential Organ Failure Assessment Score for prediction of mortality in critically ill children: A pilot study. Arch Pediatr 2020; 27:206-211. [PMID: 32278589 DOI: 10.1016/j.arcped.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/03/2020] [Accepted: 03/28/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Plasma lactate has been used to predict the prognosis of critically ill children, but mortality risk scores appear to be more appealing, particularly in resource-limited countries. OBJECTIVE To assess the prognostic utility of lactate compared with the pediatric Sequential Organ Failure Assessment (pSOFA) score among the general pediatric intensive care unit (PICU) population. METHODS This was a prospective observational study including 78 children admitted to a tertiary-level PICU. Plasma lactate was measured upon admission and repeated 24h later. pSOFA score, Pediatric Risk of Mortality, and Pediatric Index of Mortality-2 (PIM2) were calculated. The primary outcome was 30-day mortality. RESULTS In total, 47.4% of patients had hyperlactatemia at admission. Among these, 20.5% had persistent hyperlactatemia. No significant difference in admission lactate level was found between survivors and nonsurvivors. The 24-h, peak, and average lactate levels were higher among nonsurvivors (P=0.005, 0.035, and 0.019, respectively). The 24-h lactate level and pSOFA score were independent predictors of mortality (adjusted odds ratio and 95% confidence interval=1.12 [1.02-1.23] and 1.80 [1.23-2.64], respectively]. The 24-h lactate level showed positive correlations with pSOFA, PRISM, and PIM2 (Spearman correlation coefficient=0.31, 0.23, 0.43; P=0.006, P=0.047, P<0.001, respectively). The 24-h lactate level had an area under the receiver operating characteristic curve (AUC) of 0.77 (P=0.013) for mortality prediction, while admission, peak, and average lactate level had an AUC of 0.69, 0.69, 0.71 (P=0.086, P=0.035, P=0.019), respectively. PIM2, PRISM, and pSOFA score had an AUC of 0.80, 0.78, 0.82 (P=0.001, P=0.001, and P<0.001), respectively. Combining 24-h lactate level with pSOFA demonstrated superior performance (AUC=0.88). CONCLUSION Both 24-h lactate level and pSOAF are useful for prediction of mortality. Incorporating the 24-h lactate level into the pSOFA Score achieved superior prognostic utility.
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Affiliation(s)
- M S El-Mekkawy
- Department of Pediatrics, Faculty of Medicine, Menoufia University, 32511 Menoufia, Egypt.
| | - D M Ellahony
- Department of Pediatrics, Faculty of Medicine, Menoufia University, 32511 Menoufia, Egypt
| | - K A E Khalifa
- Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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孙 玉, 余 加. [Clinical value of blood lactate in predicting the prognosis of neonatal sepsis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:629-634. [PMID: 31315759 PMCID: PMC7389112 DOI: 10.7499/j.issn.1008-8830.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/22/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the clinical value of arterial blood lactate level in predicting the prognosis of neonatal sepsis. METHODS The clinical data of 301 cases of neonatal sepsis were collected, which mainly included biochemical indicators such as blood lactate on admission, C-reactive protein, and procalcitonin. ROC curves were plotted to evaluate the value of lactate level on admission in predicting the prognosis of neonatal sepsis. RESULTS The mortality rate was significantly higher for full-term infants in the severely-elevated lactate group than in the mildly-elevated lactate group and the normal lactate group (26.1% vs 3.1% and 0%; P<0.017). The poor prognosis group had a significantly increased lactate level on admission compared with the good prognosis group (6.5±5.1 mmol/L vs 3.6±1.7 mmol/L; P<0.05). The sensitivity and specificity of blood lactate level on admission (cutoff value: 6.15 mmol/L) were 0.545 and 0.919 respectively, in predicting the prognosis of neonatal sepsis. CONCLUSIONS Early blood lactate level can be used as a biochemical parameter to predict the prognosis of neonatal sepsis as it has a high specificity but a low sensitivity.
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Affiliation(s)
- 玉姗 孙
- />重庆医科大学附属儿童医院儿科研究所/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室, 重庆 400014Pediatric Research Institute, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - 加林 余
- />重庆医科大学附属儿童医院儿科研究所/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室, 重庆 400014Pediatric Research Institute, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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孙 玉, 余 加. [Clinical value of blood lactate in predicting the prognosis of neonatal sepsis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:629-634. [PMID: 31315759 PMCID: PMC7389112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/22/2019] [Indexed: 08/01/2024]
Abstract
OBJECTIVE To explore the clinical value of arterial blood lactate level in predicting the prognosis of neonatal sepsis. METHODS The clinical data of 301 cases of neonatal sepsis were collected, which mainly included biochemical indicators such as blood lactate on admission, C-reactive protein, and procalcitonin. ROC curves were plotted to evaluate the value of lactate level on admission in predicting the prognosis of neonatal sepsis. RESULTS The mortality rate was significantly higher for full-term infants in the severely-elevated lactate group than in the mildly-elevated lactate group and the normal lactate group (26.1% vs 3.1% and 0%; P<0.017). The poor prognosis group had a significantly increased lactate level on admission compared with the good prognosis group (6.5±5.1 mmol/L vs 3.6±1.7 mmol/L; P<0.05). The sensitivity and specificity of blood lactate level on admission (cutoff value: 6.15 mmol/L) were 0.545 and 0.919 respectively, in predicting the prognosis of neonatal sepsis. CONCLUSIONS Early blood lactate level can be used as a biochemical parameter to predict the prognosis of neonatal sepsis as it has a high specificity but a low sensitivity.
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Affiliation(s)
- 玉姗 孙
- />重庆医科大学附属儿童医院儿科研究所/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室, 重庆 400014Pediatric Research Institute, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - 加林 余
- />重庆医科大学附属儿童医院儿科研究所/儿童发育疾病研究教育部重点实验室/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室, 重庆 400014Pediatric Research Institute, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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Nakstad B. The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS). Infect Drug Resist 2018; 11:359-368. [PMID: 29563816 PMCID: PMC5848841 DOI: 10.2147/idr.s155965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction A key challenge in identifying serious bacterial infection in new born infants is the nonspecific clinical presentation of early-onset neonatal sepsis (EONS). Routinely used C-reactive protein, white blood cell count, and platelets are nonspecific. We assessed the diagnostic utility of single biomarkers or combinations of procalcitonin (PCT), interleukin (IL)-6, IL-8, and hyaluronic acid (HA) in newborn infant with EONS, and in human umbilical cord blood (HUCB) from deliveries with chorioamnionitis. Materials and methods Blood was collected from term infants with strictly defined EONS (group 1, n=15), healthy term infants (group 2, n=15), and the umbilical vein from pregnancies with suspected chorioamnionitis (group 3, n=8), and from healthy pregnancies with no signs of infection (group 4, n=15). Results Neonatal plasma PCT and IL-8 showed good predictive value (90% and 83%) for EONS, and the combination of IL-6 or HA with PCT increased the predictability to 87% and 90%, respectively. PCT, IL-6, IL-8, and HA were 8.4-, 4.5-, 3.6-, and 1.9-fold higher when compared with plasma levels in noninfected neonates. PCT, IL-6, and IL-8 in HUCB predicted chorioamnionitis and fever in the delivering mother (89%, 83%, and 72%, respectively). HA was a poor predictor (59%), but its predictability increased in combination with PCT, IL-8, or IL-6. In HUCB from chorioamnionitic deliveries, IL-6, IL-8, and PCT were 23-, 14-, and 2.4-fold higher, respectively, when compared with HUCB from healthy deliveries. There was no correlation between C-reactive protein, white blood cell, and platelet count with PCT, IL-6, IL-8, or HA. Conclusion In neonates that fulfilled the Norwegian consensus definition of neonatal sepsis, PCT, IL-6, and IL-8, but not HA, have the potential to improve our management of neonates at risk. Except for PCT and IL-8, both with a predictability of >80% in neonatal plasma, combinations of biomarkers increased the predictability for EONS and chorioamnionitis.
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Affiliation(s)
- Britt Nakstad
- Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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