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Newer approaches to the diagnosis of early onset neonatal sepsis

¹ Newborn Services, Royal Women’s Hospital, Melbourne, Victoria, Australia
² Department of Obstetrics and Gynaecology, and Paediatrics, University of Melbourne, Melbourne
³ Department of Microbiology and Infectious Diseases, Royal Women’s and Royal Children’s Hospitals, Melbourne

Correspondence to:
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.

Abbreviations: CRP, C reactive protein; GBS, group B streptococcus; IL, interleukin; IL1ra, IL1 receptor antagonist; PCR, polymerase chain reaction; TNF, tumour necrosis factor

Keywords: sepsis; infection; diagnosis

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