[Diagnostic value of suspicion criteria for early-onset neonatal bacterial infection: report ten years after the Anaes recommendations]
| Autor: | M, Cottineau, E, Launay, B, Branger, J, Caillon, J-B, Muller, C, Boscher, C, Laurens, B, Cabaret, J-C, Roze, C, Gras-Le Guen |
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| Jazyk: | francouzština |
| Rok vydání: | 2013 |
| Předmět: |
Calcitonin
Male Risk Calcitonin Gene-Related Peptide Infant Newborn Bacterial Infections Infant Premature Diseases Fetal Blood Infectious Disease Transmission Vertical Diagnosis Differential Hospitals University Cross-Sectional Studies Predictive Value of Tests Pregnancy Sepsis Humans Female France Empiricism Protein Precursors Biomarkers Probability Retrospective Studies |
| Zdroj: | Archives de pediatrie : organe officiel de la Societe francaise de pediatrie. 21(2) |
| ISSN: | 1769-664X |
| Popis: | Because clinical symptoms and biological markers are neither sensitive nor specific, newborns are frequently suspected of having an infection. In France, 30-50% of newborns are suspected of having early-onset sepsis (EOS) and many of them undergo laboratory tests and empirical antibiotic treatments while awaiting results. The aim of this study was to evaluate the diagnostic value of various suspicion criteria for EOS as recommended by the Anaes since 2002, and the value of umbilical cord blood procalcitonin (PCT), currently assayed in our maternity ward.This 4-year retrospective study in the CHU of Nantes included hospitalized newborns with suspected early neonatal infection. Infection status was established according to the Anaes definitions and clinical evolution.The study included 2151 newborns. Among anamnestic criteria, only prematurity significantly increased the risk of EOS (relative risk of 3.1; 95% CI 1.4-7.0). The relative risk of infection for a symptomatic newborn was 12.2 (95% CI 4.9-30.2; P0.0001). Laboratory test results were the most predictive criteria. The relative risk to be infected was 291.6 (95% CI 70.7-1,214.0; P0.0001) with a blood cord PCT value0.6 ng/L. The positive post-test probability was 28% (95% CI: 23-33) and the negative post-test probability was close to 0 (95% CI: 0-0).Clinical criteria of postnatal life adaptation are more predictive of early-onset neonatal infection than anamnestic criteria are. The blood cord PCT value could be a helpful marker in the identification of infected newborns. PCT measured in umbilical cord blood could be included in a general algorithm in order to identify as soon as possible newborns with a high risk of EOS. |
| Databáze: | OpenAIRE |
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