Conclusion: IL-6 and IL-6/IL-10 outperformed C-reactive protein to diagnose neonatal sepsis. Of the cytokines studied, IL-6 was the most sensitive, whereas IL-6/IL-10 was the most specific predictor of neonatal sepsis.
- Qing Ye, Li-Zhong Du, Wen-Xia Shao, Shi-Qiang Shang
Oct 01, 2020 · The most common early signs of sepsis in infants are fever or hypothermia, tachypnoea, lethargy, or new parental reports of poor feeding. Consider sepsis in infants with an apparent change in mental status, tone, or perfusion as well
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Jan 28, 2019 · Sepsis is a life-threatening dysfunction of the immune system leading to multiorgan failure that is precipitated by infectious diseases and is a leading cause of death in children under 5 years of age. It is necessary to be able to identify a sick child at risk of developing sepsis at the earliest point of presentation to a healthcare facility so that appropriate care can be provided as soon ...
- Jollee S. T. Fung, Samuel Akech, Niranjan Kissoon, Matthew O. Wiens, Mike English, J. Mark Ansermino
Aug 08, 2019 · Neonatal sepsis is a common, deadly problem with global impact including significant morbidity and mortality, even in high-resource countries. 1,2 The greatest incidence and impact of neonatal ...
- James L Wynn, Richard A Polin
Dec 01, 2018 · In particular, the Neonatal Early-Onset Sepsis Risk Calculator does not apply to infants born before 34 0/7 weeks’ gestation. 36 The objective of EOS risk assessment among preterm infants is, therefore, to determine which infants are at the lowest risk for infection and who, despite clinical instability, may be spared administration of empirical antibiotics.
- Karen M. Puopolo, Karen M. Puopolo, William E. Benitz, Theoklis E. Zaoutis, Newborn
The total white blood cell count and absolute band count in neonates are poor predictors of early-onset sepsis. However, an elevated ratio of immature:total polymorphonuclear leukocytes of > 0.16 is sensitive, and values below this cutoff have a high negative predictive value.
Early-onset sepsis and early-onset meningitis were defined by isolation of a pathogen from blood or cerebrospinal fluid (CSF) culture obtained within 72 hours after birth and treatment with antibiotics for at least 5 days (<5 days if death occurred while receiving antibiotics).
Nov 06, 2012 · To investigate the predictive power of HC, funisitis, and CPV in diagnosing early-onset sepsis in full-term infants, Dr. Hakima and colleagues reviewed the surgical pathology records of ...
- Author Contributions
- Conflict of Interest Statement
- Supplementary Material
Significant progresses have been made over the past two decades in reducing global under-5 mortality from 91 deaths per 1,000 live births in 1990 to 43 deaths per 1,000 live births in 2015 (1). However, mortality in neonates (under 28 days of age) and infants (under 1 year of age) remains disproportionately high, representing over two-thirds of under-5 deaths in children below 5 years of age (2). Of these deaths, 90% occur in developing countries (3), with the highest neonatal mortality rates occurring in Sub-Saharan Africa. Thus, interventions among neonates and infants are urgently needed in these countries if the recent UN Sustainable Development Goals are to be achieved, targeting to decrease under-5 mortality to < 25 per 1,000 live births and neonatal mortality to < 12 per 1,000 live births by 2030 (4, 5). Reducing mortality in neonates and young infants has lagged significantly behind that of older pediatric populations (6). Although no consensus has been made, some studies su...
Study Eligibility Criteria and Systematic Search
This systematic review focused on children < 1 year old evaluated for sepsis or other serious infections in LMICs. Study eligibility was defined according to the conventional Populations, Interventions, Comparators, Outcomes, and Study Design (PICOS) criteria, determined a priori (Table 1). A study was included if (i) it presented original data from either a prospective or retrospective cohort study or from a randomized controlled trial, (ii) the majority of the subjects were under 1 year of...
Study Selection and Data Extraction
Two investigators (LL and NK) independently conducted two rounds of review to determine study eligibility among identified articles. Articles were first screened based on the abstract using the PICOS criteria defined in Table 1, where articles clearly meeting exclusion criteria were immediately discarded. A second round of review involved screening the remaining manuscripts in full text, to determine final eligibility. At both stages, discrepancies were resolved by consensus or by arbitration...
Outcomes and Data Analysis
The primary aim of this systematic review was to determine the risk factors for mortality among neonates and infants hospitalized with an infectious process in developing countries. All risk estimates pertain to in-patient mortality, except those specifically noted as risk factors for outpatient (i.e., post-discharge) mortality. As all studies were interpreted from a cohort design perspective, their quality was assessed using the Newcastle-Ottawa Scale (16). Each study was reviewed by one inv...
Summary of Included Articles
Through the systematic literature search, 1,139 abstracts were identified. Of these, 970 were excluded during the abstract screening stage. The full-text of the remaining 169 articles were reviewed, after which an additional 124 articles were excluded. Thus, a total of 45 articles were included (Figure 1) (17–62). Among these 45 studies, the majority of studies were prospective or retrospective cohort studies (Tables 3, 4). Upon assessment using the Newcastle-Ottawa scale, the average score f...
This systematic review focused on risk factors of mortality among hospitalized neonates and infants under 1 year of age due to infectious causes in LMICs. To the best of our knowledge, this is the first systematic literature review that focuses of clinical predictors of mortality from severe infection among hospitalized neonates and infants in developing countries. Most previous work on these populations consist of single population-based studies (11, 63). Previous systematic reviews of clinical predictors of mortality from severe infections have included infants in developed countries, which may not applicable to areas of the world where the majority of the disease burden occurs (10). Furthermore, other systematic reviews have examined predictors of severe illness and/hospitalization rather than mortality (64, 65), the latter which is a more objective, directly actionable outcome for use in intervention trials. Moreover, other previous work have focused on on all-cause mortality fr...
This systematic review summarizes risk factors for mortality among neonates and infants in LMICs. Our data highlight major risk factors that could be incorporated into risk-prediction models to identify children at risk for in-hospital or post-discharge mortality. This data also points toward specific interventions that could be further incorporated into healthcare systems or policies. Targeted, evidence-based interventions have the potential to vastly reduce the burden of preventable mortality among neonates and infants around the world. Future studies in this area should incorporate precise definitions and risk estimates for mortality, including larger sample sizes, detailed statistical analysis, and overlapping risk factors between these high-risk age groups.
LL prepared first draft of manuscript, conducted systematic search and data extraction, assisted in analysis of data, approved final version of manuscript. NaK and LE conducted systematic search and data extraction, assisted in analysis of data, approved final version of manuscript. NiK, PL, JA, and JK reviewed and edited manuscript and provided critical interpretation of data, assisted in analysis of data, approved final version of manuscript. MW conceived study idea, assisted in systematic search and data extraction, assisted in analysis of data, reviewed and edited manuscript and provided critical interpretation of data, approved final version of manuscript.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fped.2018.00277/full#supplementary-material
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