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Current diagnostic criteria of neonatal sepsis and systemic inflammatory response in the fetus and the newborn


Authors: K. Boráková 1;  Z. Straňák 1,2
Authors‘ workplace: Ústav pro péči o matku a dítě, Praha 1;  3. lékařská fakulta, Univerzita Karlova, Praha 2
Published in: Čes-slov Pediat 2021; 76 (1): 46-54.
Category: Review

Overview

Neonatal sepsis (NS) is one of the most serious complications of the neonatal period with high mortality and severe long-term morbidity. Neonatal sepsis is currently also very often the cause of litigations between the child's legal guardians and health care providers. Adequate diagnosis and early therapy of NS are essential factors that can affect the child´s prognosis. However, optimal management of NS depends not only on the exact assessment of available clinical and laboratory data of the newborn, but also on the precise analysis of the course of pregnancy and childbirth.

In this comprehensive paper, authors present the complex issue of NS, the basic classification of neonatal sepsis, current definitions of NS, recommended clinical and laboratory procedures in the diagnosis of NS, fetal inflammatory response syndrome (FIRS), systemic inflammatory response syndrome (Systemic Inflammatory Response Syndrome, SIRS) in the neonate and the new organ failure scoring system.

Keywords:

Neonatal sepsis – Systemic inflammatory response syndrome – definition – diagnosis


Sources

1. Puopolo KM, Benitz WE, Zaoutis TE. Management of neonates born at ≤34 6/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018; 142 (6): e20182896.

  2.    Zach J. Sepse. In: Janota J, Straňák Z. Neonatologie. Praha: Mladá fronta, 2013: 408–418.

  3.    Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 2016; 315 (8): 801–810.

  4.    Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am 2013; 60 (2): 367–389.

  5.    van den Hoogen A, Gerards LJ, Verboon-Maciolek MA, et al. Long-term trends in the epidemiology of neonatal sepsis and antibiotic susceptibility of causative agents. Neonatology 2010; 97: 22–28.

  6.    Puopolo KM, Eichenwald EC. No change in the incidence of ampicillin-resistant, neonatal, early-onset sepsis over 18 years. Pediatrics 2010; 125: e1031–e1038.

  7.    Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390 (10104): 1770–1780.

  8.    Ebenebe C, Hesse F, Blohm M, et al. Diagnostic accuracy of interleukin-6 for early-onset sepsis in preterm neonates. J Matern Fetal Neonatal Med 2019; 1–6.

  9.    Hofer N, Kothari R, Morris N, et al. The fetal inflammatory response syndrome is a risk factor for morbidity in preterm neonates. Am J Obstet Gynecol 2013; 209: 542. e1–11.

10.    INIS Collaborative Group, Brocklehurst P, Farrell B, et al. Treatment of neonatal sepsis with intravenous immune globulin. N Engl J Med 2011; 365 (13): 1201–1211 (reference k senzitivitě hemokultury – 40 %).

11.    Kasper DC, Altiok I, Mechtler TP, et al. Molecular detection of late-onset neonatal sepsis in premature infants using small blood volumes: proof-of-concept. Neonatology 2013; 103 (4): 268–273 (reference k senzitivitě hemokultury – 88 %).

12.    Fjalstad JW, Stensvold HJ, Bergseng H, et al. Early-onset sepsis and antibiotic exposure in term infants: A Nationwide Population-based Study in Norway. Pediatr Infect Dis J 2016; 35 (1): 1–6 (reference k podávání ATB).

13.    Stocker M, van Herk W, El Helou S, et al. Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns). Lancet 2017; 390 (10097): 871–881 (reference k podávání ATB).

14.    Weston EJ, Pondo T, Lewis MM, et al. The burden of invasive early-onset neonatal sepsis in the United States, 2005–2008. Pediatr Infect Dis J 2011; 30: 937–941.

15.    Borghesi A, Tzialla C, Decembrino L, et al. New possibilities of prevention of infection in the newborn. J Matern Fetal Neonatal Med 2011; 24 (Suppl 2): 28–30.

16.    Klingenberg C, Kornelisse RF, Buonocore G, et al. Culture-negative early-onset neonatal sepsis – at the crossroad between efficient sepsis care and antimicrobial stewardship. Front Pediatr 2018; 6: 285.

17.    Puopolo KM, Benitz WE, Zaoutis TE. Management of neonates born at ≥35 0/7 weeks‘ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018; 142 (6). pii: e20182894.

18.    Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101 (6): 1644–1655 (reference k SIRS).

19.    Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6 (1): 2–8.

20.    Wynn JL. Defining neonatal sepsis. Curr Opin Pediatr 2016; 28 (2): 135–40.

21.    Hofer N, Müller W, Resch B. Systemic inflammatory response syndrome (SIRS) definition and correlation with early-onset bacterial infection of the newborn. Arch Dis Child Fetal Neonatal Ed 2010; 95 (2): F151–F151.

22.    Hofer N, Müller W, Resch B. Definitions of SIRS and sepsis in correlation with early and late onset neonatal sepsis. J Pediatr Intensive Care 2012; 1(1): 17–23.

23.    European Medicines Agency. Report on the Expert Meeting on Neonatal and Paediatric Sepsis. 2010; EMA London; https://www.ema.europa.eu/en/documents/report/report-expert-meeting-neonatal-paediatric-sepsis_en.pdf.

24.    Tuzun F, Ozkan H, Cetinkaya M, et al. Is European Medicines Agency (EMA) sepsis criteria accurate for neonatal sepsis diagnosis or do we need new criteria? PLoS One 2019; 6; 14 (6): e0218002. doi: 10.1371/journal.pone.0218002.

25.    Neonatal Early-Onset Sepsis Calculator, Kaiser Permanente Research: https://neonatalsepsiscalculator.kaiserpermanente.org.

26.    Stoll BJ, Hansen NI, Bell EF, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA 2015; 314 (10): 1039–1051.

27.    Simonsen KA, Anderson-Berry AL, Delair SF, et al. Early-Onset Neonatal Sepsis. Clin Microbiol Rev 2014; 27 (1): 21–47.

28.    Wynn JL, Polin RA. Progress in the management of neonatal sepsis: the importance of a consensus definition. Pediatr Res 2018; 83 (1–1): 13–15. doi: 10.1038/pr.2017.224. Epub 2017 Oct 11.

29.    Wynn JL, Polin RA. A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants. Pediatr Res 2019; doi: 10.1038/s41390-019-0517-2. Epub 2019 Aug 08.

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Neonatology Paediatrics General practitioner for children and adolescents
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