Newer approaches to the diagnosis of early onset neonatal sepsis (original) (raw)

Newer approaches to the diagnosis of early onset neonatal sepsis

U K Mishra1,
S E Jacobs1,
L W Doyle1,2,
S M Garland2,3
1Newborn Services, Royal Women’s Hospital, Melbourne, Victoria, Australia
2Department of Obstetrics and Gynaecology, and Paediatrics, University of Melbourne, Melbourne
3Department of Microbiology and Infectious Diseases, Royal Women’s and Royal Children’s Hospitals, Melbourne
Correspondence to:
Professor Garland
Clinical Microbiology and Infectious Diseases, Royal Women’s Hospital, 132 Grattan St, Carlton, Victoria 3053, Australia; suzanne.garland{at}rch.org.au

Abstract

Accurate and timely diagnosis of early onset neonatal sepsis remains challenging to the clinician and the laboratory. A test with a rapid turnaround time with 100% sensitivity, rather than high specificity, which allows accurate diagnosis and appropriate antimicrobial treatment or which allows antibiotics to be safely withheld in non-infected infants, is desirable. Many potential markers (acute phase reactants, cell surface markers, cytokines) are not routinely available to the laboratory, and most likely combinations of markers will ensure greater diagnostic accuracy. In the future, molecular biology techniques offer the prospect of rapid identification of both pathogens and antimicrobial resistance markers.

CRP, C reactive protein
GBS, group B streptococcus
IL, interleukin
IL1ra, IL1 receptor antagonist
PCR, polymerase chain reaction
TNF, tumour necrosis factor
sepsis
infection
diagnosis

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Fantoms
Archives of Disease in Childhood - Fetal and Neonatal Edition 2006; 91 F157-F157 Published Online First: 21 Apr 2006.