دورية أكاديمية
C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-onset Sepsis Within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study.
| العنوان: | C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-onset Sepsis Within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study. |
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| المؤلفون: | Stocker M; Department of Paediatrics, Neonatal and Paediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, Switzerland., van Herk W; Department of Paediatrics, Division of Paediatric Infectious Diseases & Immunology, Erasmus Medical Centre, University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands., El Helou S; Division of Neonatology, McMaster University Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada., Dutta S; Division of Neonatology, McMaster University Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada., Schuerman FABA; Department of Neonatal Intensive Care Unit, Isala Women and Children's Hospital, Zwolle, The Netherlands., van den Tooren-de Groot RK; Department of Paediatrics, Haaglanden Medical Centre, 's Gravenhage, The Netherlands., Wieringa JW; Department of Paediatrics, Haaglanden Medical Centre, 's Gravenhage, The Netherlands., Janota J; Department of Obstetrics and Gynocology, Second Medical Faculty, Motol University Hospital, Prague, Czech Republic.; First Medical Faculty, Czech Republic and Institute of Pathological Physiology, Prague, Czech Republic., van der Meer-Kappelle LH; Department of Neonatology, Reinier de Graaf Gasthuis, Delft, The Netherlands., Moonen R; Department of Neonatology, Zuyderland Medical Centre, Heerlen, The Netherlands., Sie SD; Department of Neonatology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., de Vries E; Department of Paediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Donker AE; Department of Paediatrics, Maxima Medical Centre, Veldhoven, The Netherlands., Zimmerman U; Department of Paediatrics, Kantonsspital Winterthur, Winterthur, Switzerland., Schlapbach LJ; Paediatric Critical Care Research Group, Child Health Research Centre, University of Queensland, Brisbane, Australia.; Padiaitric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia.; University Children's Hospital Zurich and University of Zurich, Zurich, Switzerland., de Mol AC; Department of Neonatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Hoffman-Haringsma A; Department of Neonatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands., Roy M; Department of Neonatology, St. Josephs Healthcare, Hamilton Health Sciences, Hamilton, Ontario, Canada., Tomaske M; Department of Paediatrics, Stadtspital Triemli, Zürich, Switzerland., F Kornelisse R; Department of Paediatrics, Division of Neonatology, Erasmus Medical Centre, University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands., van Gijsel J; Therapeuticum Utrecht, Utrecht, The Netherlands., Visser EG; Department of Paediatrics, Division of Paediatric Infectious Diseases & Immunology, Erasmus Medical Centre, University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands., Plötz FB; Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands., Heath P; Department of Paediatric Infectious Disease, St George's University Hospital, London, United Kingdom., Achten NB; Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands., Lehnick D; Department of Health Sciences and Medicine, Head Biostatistics and Methodology, University of Lucerne, Lucerne, Switzerland., van Rossum AMC; Department of Paediatrics, Division of Paediatric Infectious Diseases & Immunology, Erasmus Medical Centre, University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. |
| المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Jul 15; Vol. 73 (2), pp. e383-e390. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Comment |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| مواضيع طبية MeSH: | Neonatal Sepsis*/diagnosis , Sepsis*/diagnosis, Biomarkers ; C-Reactive Protein/analysis ; Calcitonin ; Humans ; Infant, Newborn ; Procalcitonin ; Prospective Studies ; ROC Curve |
| مستخلص: | Background: Neonatal early-onset sepsis (EOS) is one of the main causes of global neonatal mortality and morbidity, and initiation of early antibiotic treatment is key. However, antibiotics may be harmful. Methods: We performed a secondary analysis of results from the Neonatal Procalcitonin Intervention Study, a prospective, multicenter, randomized, controlled intervention study. The primary outcome was the diagnostic accuracy of serial measurements of C-reactive protein (CRP), procalcitonin (PCT), and white blood count (WBC) within different time windows to rule out culture-positive EOS (proven sepsis). Results: We analyzed 1678 neonates with 10 899 biomarker measurements (4654 CRP, 2047 PCT, and 4198 WBC) obtained within the first 48 hours after the start of antibiotic therapy due to suspected EOS. The areas under the curve (AUC) comparing no sepsis vs proven sepsis for maximum values of CRP, PCT, and WBC within 36 hours were 0.986, 0.921, and 0.360, respectively. The AUCs for CRP and PCT increased with extended time frames up to 36 hours, but there was no further difference between start to 36 hours vs start to 48 hours. Cutoff values at 16 mg/L for CRP and 2.8 ng/L for PCT provided a sensitivity of 100% for discriminating no sepsis vs proven sepsis. Conclusions: Normal serial CRP and PCT measurements within 36 hours after the start of empiric antibiotic therapy can exclude the presence of neonatal EOS with a high probability. The negative predictive values of CRP and PCT do not increase after 36 hours. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.) |
| التعليقات: | Comment in: Clin Infect Dis. 2021 Jul 15;73(2):e391-e393. (PMID: 32881996) Comment on: Clin Infect Dis. 2021 Jul 15;73(2):e391-e393. (PMID: 32881996) |
| فهرسة مساهمة: | Keywords: C-reactive protein; negative predictive value; neonatal early-onset sepsis; procalcitonin; white blood count |
| المشرفين على المادة: | 0 (Biomarkers) 0 (Procalcitonin) 9007-12-9 (Calcitonin) 9007-41-4 (C-Reactive Protein) |
| تواريخ الأحداث: | Date Created: 20200904 Date Completed: 20210804 Latest Revision: 20210804 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1093/cid/ciaa876 |
| PMID: | 32881994 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1537-6591 |
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| DOI: | 10.1093/cid/ciaa876 |