Original ArticlesPremature infants respond to early-onset and late-onset sepsis with leukocyte activation☆
Section snippets
METHODS
The study was approved by the New England Medical Center Human Investigation Review Committee. Verbal consent was obtained after a statement of participation was read to the parents. The sample of blood was the blood remaining in the tubing and syringe at the time a clinical blood sample was obtained for analysis.
Study Population
Twenty-one infants enrolled in the study had multiple sepsis evaluations and had more than one sample available for a paired observation. Of note, 5 individual infants had 3 different samples obtained that were assigned at different times to each clinical group. The median gestational age of the infants was 25 weeks (range, 24-30 weeks). The median birth weight was 762 g (range, 854-1295 g); 16 infants (76%) were male. There were 8 (38%) vaginal deliveries and 13 (62%) cesarean sections. The
DISCUSSION
The tests currently used to diagnose bacterial sepsis are neither sensitive nor specific in the neonatal period. Manroe et al6 described reference ranges for neonatal neutrophil counts in both healthy infants and infants with sepsis. In this large study, neutropenia and an immature to total neutrophil ratio >0.16 were the most informative in predicting sepsis. However, the neutrophil count and an immature to total neutrophil ratio had a sensitivity of only 77% and 50%, respectively, and the
References (17)
Clinicopathologic approach to the diagnosis of neonatal sepsis
Clin Perinatol
(1991)- et al.
The neonatal blood count in health and disease. I. Reference values for neutrophilic cells
J Pediatr
(1979) - et al.
Effect of number of blood cultures and volume of blood on detection of bacteremia in children
J Pediatr
(1996) - et al.
Circulating lymphocyte subsets in second and third trimester fetuses: comparison with newborns and adults
Am J Obstet Gynecol
(1992) - et al.
Altered leukocyte immunophenotypes in septic shock
Chest
(1993) - et al.
Neutrophil CD11b expression as a diagnostic marker for early-onset neonatal infection
J Pediatr
(1998) - et al.
Bacterial sepsis and meningitis
The changing face of neonatal infection: experience at a regional medical center
Pediatr Infect Dis J
(1994)
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Normal and Abnormal Neutrophil Physiology in the Newborn
2017, Fetal and Neonatal Physiology, 2-Volume SetTranslational research and biomarkers in neonatal sepsis
2015, Clinica Chimica ActaCitation Excerpt :Contradictory lower serum CD11b levels have been reported in neonates with sepsis by Cui et al. [110]. Another study could not confirm the diagnostic value of this integrin family member in neonatal sepsis [111]. Different study populations and technical differences in measurement methods might explain the controversal findings among the published trials [93].
CD4+/CD25+ lymphocytes in peripheral vein blood of preterm newborns
2013, Pediatria PolskaThe Use of Biomarkers for Detection of Early- and Late-Onset Neonatal Sepsis
2012, Hematology, Immunology and Infectious Disease: Neonatology Questions and ControversiesIntegrins and Cell Adhesion Molecules
2011, Fetal and Neonatal Physiology E-Book, Fourth EditionLaboratory evaluation of neonatal sepsis
2010, Newborn and Infant Nursing Reviews
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Reprint requests: Diana W. Bianchi, MD, Division of Newborn Medicine, New England Medical Center, 750 Washington St, Box No. 394, Boston, MA 02111.