Adjunct Laboratory Tests in the Diagnosis of Early-Onset Neonatal Sepsis

Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 750 Welch Road, Suite 315, Stanford, Palo Alto, CA 94304, USA. <>
Clinics in perinatology (Impact Factor: 2.44). 06/2010; 37(2):421-38. DOI: 10.1016/j.clp.2009.12.001
Source: PubMed


Early-onset sepsis remains a major diagnostic problem in neonatal medicine. Definitive diagnosis depends on cultures of blood or other normally sterile body fluids. Abnormal hematological counts, acute-phase reactants, and inflammatory cytokines are neither sensitive nor specific, especially at the onset of illness. Combinations of measurements improve diagnostic test performance, but the optimal selection of analytes has not been determined. The best-established use of these laboratory tests is for retrospective determination that an infant was not infected, based on failure to mount an acute-phase response over the following 24 to 48 hours.

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Available from: William Benitz, Jan 15, 2015
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    • "The combined measurement of a cytokine (IL-6 or IL-8) and CRP is currently considered as the most reliable method with the highest sensitivity and specificity for early diagnosis of both EONS and LONS [27]. IL-6 detects sepsis at an early stage of infection with a maximum of serum levels as early as 1-2 hours after inflammation reaction has started, potentially even prior to onset of clinical symptoms [28]. "
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    • "Because of the high negative predictive value, screening panels may produce a significant decrease in the use of antimicrobial agents. With their use, fewer neonates would receive antimicrobial agents, and antibiotic treatment could be more confidently discontinued earlier.12,14 "
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