Keywords
Procalcitonin
Umbilical Cord
Neonatal Sepsis
Infant Premature
Umbilical Cord
Neonatal Sepsis
Infant Premature
How to Cite
López-Garrido, E., González-Quintanilla, M. A., Berlanga-Bolado, O. M., Fortuna Reyna, B. de J., & Rivera-Vázquez, P. (2018). Umbilical cord blood serum procalcitonin as predictor of early onset sepsis in premature infants in Tamaulipas México, 2016. Preliminary results. Médicas UIS, 31(1), 23–30. https://doi.org/10.18273/revmed.v31n1-2018003
Abstract
Introduction: sepsis is a cause of high mortality in the premature, it affects up to 19 of 1000 in children under 1000 g and its manifestation may be nonspecific. Decision-making on the use of antibiotics is not always easy, so it is worth having an fast, cheap and effective predictor of early onset sepsis. Objective: to determine the use of serum procalcitonin umbilical cord as a predictor of early onset sepsis in preterm infants. Materials and methods: longitudinal descriptive study from june to november 2016 was made. 22 preterm infants (<37 weeks of gestation) were included, with or without risk factors for infection. Neonates with malformations or suspicion of metabolic disease were excluded. A blood sample was taken from the umbilical artery for procalcitonin and blood culture at birth, subsequently they were assessed from birth to 72 hours of life for sepsis data. Results: twelve developed early onset sepsis and ten did not. The mean procalcitoninof umbilical cord in the sepsis group was 0.68 ng/ml versus 0.13 ng/ml in the group without sepsis, p=0.025. In the analysis under the ROC curve area for procalcitonin was 0.75. The cut value of umbilical cord procalciton was 0.14 ng/ml as a predictor of early sepsis (sensitivity 75%, specificity 70%, positive predictive value 75%, negative predictive value 70%). Conclusions: procalcitonin of umbilical cord at birth may be a useful parameter as a marker of early onset sepsis in the premature, however these results must be validated with a larger sample size. MÉD.UIS. 2018;31(1):23-30.
References
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5. Coto GD, Ibáñez A. Protocolo diagnóstico-terapéutico de la sepsis neonatal. Bol Pediatr. 2006;46(Supl 1):125-34.
6. Hospital Infantil de México Federico Gómez. Sepsis Bacteriana del Recién Nacido, No Especificada En: Guías clínicas del Departamento de Neonatología. México: Instituto Nacional de
Salud; 2011. 1-14.
7. Gutiérrez-Muñoz V, Gutiérrez-Muñoz J, Rosas V. Factores de riesgo en sepsis neonatal en un hospital de tercer nivel en la ciudad de México. Rev Esp Med Quir. 2005;10(2):21-4.
8. Coronell W, Perez C, Guerrero C, Bustamante H. Sepsis neonatal.Rev enfermedades infecc ped. 2009;23(90):57-68.
9. Peter G, Cashore WJ. Infections acquired in the nursery: epidemiology and control. En: Remington JS, Klein JO, editores. Infectious diseases of the fetus and newborn infant. Fifth edition. Philadelphia: Saunders; 2001. p. 1264-83.
10. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS,Wenzel RP. The natural history of the systemic inflammatory response syndrome (SRIS). A prospective study. JAMA.1995;273(2):117-23.
11. Munford R. Sepsis y shock séptico. En: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, editores. Harrison, Principios de Medicina Interna. 14ª Edición. Mc. Graw-Hill, Interamericana; 1998. p. 885–91.
12. Avila Reyes R, Rangel Garcia R, Herrera Pen M, Camacho Ramirez I, Velazquez Quintana NI. Síndrome de Respuesta Inflamatoria Sistémica en recién nacidos menores de 1 500 gramos. Enf Inf Microbiol. 2014;34(3):86-91.
13. Pugin J, Meisner M, Leon A, Gendrel D, Fernandez A. Guide for the cllinical use of procalcitonin in sepsis diagnosis BRAHMS.2004:4-23.
14. Martínez-Leon AF, Arduz-Eguino E, Calderón-López ME. Sensibilidad y especificidad de la procalcitonina y tinción de gram de Buffy coat para el diagnóstico temprano de sepsis en pacientes pediátricos. Gac Med Bol 2011; 34(1):20-24.
15. Connell TG, Rele M, Cowley D, Buttery JP, Curtis N. How reliable is a negative blood culture result? Volume of blood admitted for culture in routine practice in a children’s hospital. Pediatrics 2007; 119(5):891–6.
16. Hedegaard S , Wisborg K, Hvas A. Diagnostic utility of biomarkers for neonatal sepsis - a systematic review. Scand J Infect Dis . 2015; 47(3): 117–124.
17. Chiesa C, Signore F, Assumma M, Buffone E, Pacifico L, Tramontozzi P, et al. Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: Reference intervals and analysis of maternal and perinatal confounders.
Clin Chem 2001; 47(6):1016–22.
18. Auriti C, Fiscarelli E, Ronchetti MP, Argentieri M, Buonocore
G, Prencipe G. Procalcitonin in detecting neonatal nosocomial
sepsis. Arch Dis Child Fetal Neonatal Ed. 2012; 97(5):F368–70.
19. Vouloumanou EK, Plessa E, Karageorgopoulos D, Mantadakis
E, Falagas M. Serum procalcitonin as a diagnostic marker for
neonatal sepsis: a systematic review and meta-analysis. Intensive
Care Med. 2011; 37(5):747–62.
20. Genel F, Atlihan F, Gulez N, kazanci E, Vergin C, Tumay-Terek D,
et al. Evaluation of adhesion molecules CD64, CD11b and CD62L
in neutrophils and monocytes of peripheral blood for early
diagnosis of neonatal infection. World J Pediatr. 2011; 8(1):72–5.
21. Pammi M, Brocklehurst P. Granulocyte transfusions for neonates
with confirmed or suspected sepsis and neutropenia. Cochrane
DB Syst Rev. 2011:CD003956.
22. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal
Infectious Diseases: Evaluation of Neonatal Sepsis. Pediatr Clin
N Am 2013; 60(2):367-389.
23. Stocker M, Fontana M, El Helou S, Wegscheider K and Merger
TM. use of procalcitonin-guided decision-making to shorten
antibiotic therapy in suspected neonatal early-onset sepsis:
prospective randomised intervention trial. Neonatology 2010;
97(2):165-74.
24. Reinhart K, Meisner M, Brunkhorst F. Markers for sepsis
diagnosis: What is useful? Critical Care Clinic. 2006;22(3):503-
519.
25. Islas-Domínguez L, Cardiel-Marmolejo L, Sánchez-Medina O.
Septicemia neonatal temprana. ¿Cuándo iniciar antibióticos?
Rev. mex. pediatr. 2012; 79 (1):12-17.
26. Reimer LG,Wilson ML, Weinstein MP. Update on detection of
bacteremia and fungemia. Clin. microbiol. rev. 1997; 10 (3):444-465.
27. Polin R, et al. Management of Neonates With Suspected or Proven
Early-Onset Bacterial Sepsis. Pediatrics. 2012; 129(5): 1006-1015.
28. Chiesa et al. Diagnosis of Neonatal Sepsis. Clin. chem. 2001; 50
(2): 254-287.
29. Deleon C, Shattuck K, Jain S. Biomarkers of Neonatal Sepsis.
NeoReviews. 2015; 16(5): 297- 308.
30. Arnon S, Litmanovitz I. Diagnostic tests in neonatal sepsis. Curr.
opin. infect. dis. 2008; 21(3):223–227.
31. Ventetuolo C, Levy M. Biomarkers: Diagnosis and Risk
Assessment in Sepsis. Clin. chest med. 2008; 29(4): 591–603.
32. Sierra R. C-Reactive Protein and Procalcitonin as Markers of
Infection, Inflammatory Response, and Sepsis. Clin. pulm. med.
2007; 14 (3): 127-139.
33. Penders J, Thijs C, van den Brandt PA, Kummeling I, Snijders B,
Stelma F, et al. Gut microbiota composition and development of
atopic manifestations in infancy: 354 the KOALA Birth Cohort
Study. Gut. 2007; 56(5):661-7.
34. Neu J. Perinatal and neonatal manipulation of the intestinal microbiome: a note of caution. Nutr. Rev. 2007; 65(6):282-285.
35. Kordek A, Giedrys-Kalemba S, Pawlus B, Podraza W, Czajka R.
Umbilical Cord Blood Serum Procalcitonin Concentration in
the Diagnosis of Early Neonatal Infection. J. perinatol. 2003;
23(2):148–153.
36. Joram M, Bosher C, Demzot S, Loubersac V, Winer N, Roze JC,
et al. Umbilical cord blood procalcitonin and C reactive protein
concentrations as markers for early diagnosis of very early
onset neonatal infection. Arch Dis Child Fetal Neonatal. 2006;
91(1):65-66.
37. Chaouachi s, Marrakchi O, Ben Amida E, Abidi K, Bechir
Z, Abdel Moula S, et al. Apport de la procalcitonine dans le
diagnostic precoce del infection materno-foetale bacterienne.
Elude prospective. Archives de pediatrie. 2011; 18:267-71.
38. Joram N, Muller JB, Denizot S, Orsonneau JL, Caillon J. Rozé
JC, Guen GL. Umbilical cord blood procalcitonin level in early
neonatal infections: a 4-year university hospital cohort study.
Eur Jour of Clin Micr and Infect Dis. 2011; 30:1005-1013.
39. Su H, Chang S-S, Han CM, Wu K-Y, Li MC, Huang CY, et al.
Inflammatory markers in cord blood or maternal serum for
early detection of neonatal sepsis-a systemic review and metaanalysis.
Journal of Perinatology. 2014;34:268-274.
40. Cetin O, Aydin ZD, Verit FF, Zebitay AG, Karaman E, Elasan S,
et al. Is maternal blood Procalcitonin level a reliable predictor
for early onset neonatal sepsis in preterm premature rupture of
membranes?. Gynecol Obstet Invest. 2017;82(2):163-169.
41. Rueda-Salguero OO, Beceiro- Mosqueda J, Barrionuevo-Gonzalez
M, Ripaldo-Crespo MJ, Olivas López De Soria C. Procalcitonina
en sangre de cordon en la valoración del riesgo de sepsis neonatal
precoz. An Pediatr. 2017;87(2):87-94
42. Lim WH, Lien R, Huang YC, Chiang MC, Fu RH, Chu SM, et al.
Prevalence and Pathogen Distribution of Neonatal Sepsis Among
Very-Low-Birth-Weight Infants. Pediatr Neonatol. 2012;53(4):228-
234.
43. Brookfield KF, El-Sayed YY, Chao L, Berger V, Naqvi M,
Butwick AJ. Antenatal corticosteroids for preterm premature
rupture of membranes: single or repeat course?. Am J Perinatol.
2015;32(6):537.544.
44. Bamonde L, Camaño B, Alonso M. La procalcitonina como
marcador de infección. Una revisión desde atención primaria.
Rev Pediatr Aten Primaria. 2002;4:619-630.
45. Roqués V, Fernández C, Gormaz M. Cabezas M.A. Procalcitonina
como marcador de infección neonatal. Acta Pediatrica.
1997;86:209
46. Bartolovic D, Ignjatovic S, Stankovic S, Majkic N. Procalcitonina
and other biomarkers of sepsis in newborn in the Intensive Care
Unit. EJIFCC. 2011 Mar; 22(1): 24–30.
47. Fernández Colomer B, López Sastre J, Coto Cotallo G, Ramos
Aparicio A, Ibáñez Fernández A. Sepsis del recién nacido.
Protocolos Diagnóstico Terapéuticos de la AEP: Neonatología.
2008.
48. Töllner U. Early Diagnosis of septicemia in the Newborn. Clinical
studie and sepsis score. Eur J Pediatr 1982;138:331-337.
49. Hofer N, Miiller W, Resh B. Systemic inflammatory response
síndrome (SIRS) definition and correlation with early-onset
bacterian infection of the newborn. 2010;95(2):151.
50. Gonzalez-Osoyo M, O-Vizcarra M, Garibay-González F.
Identificación de marcadores hematológicos para el diagnóstico
de sepsis neonatal temprana en el Hospital Militar Regional de
Irapuato, Guanajuato. Revi Sanid Milit. [Internet] Nov - Dic 2006.
60(6):390-396. Disponible en: http://www.medigraphic.com/cgibin/
new/resumen.cgi?IDARTICULO=14542
51. Stein M, Schachter-Davidov A, Babai I, Tasher D, Somekh E. The
accuracy of C-reactive proteín, procalcitonin, and s-TREM-I in
the prediction of serious bacterial infection in neonates. Clin.
pediatr. 2015; 54 (5): 439-444.
52. Lewis D B, Wilson C B. Developmental immunology and role of
host defenses in fetal and neonatal susceptibility to infection.
In: Remington JS, Klein JO, eds. Infectious Disease of Fetus,
Newborn, and Infants. 7th ed. Philadelphia, PA: WB Saunders;
2011 : 80-172.
53. Kordek A, Torbé A, Tousky J, Loniewska B, et al. The
determination of procalcitonin concentration in Early-Onset
Neonatal Infection: A valuable test Regardless of Prenatal
Antibiotic Therapy. Clin. Pediatr. 2017;56(4):333-340.
54. Resch B, Gusenleitner W, Muller WD. Procalcitonin and
interleukine 6 in the diagnosis of early-onset sepsis of the
neonate. Acta paediatr. 2003; 92(2):243-245.
55. Gendrel D, Assicot M, Raymond J, Moulin F, Francoual C, Badoual
J, Bohuon C. Procalcitonin as a marker for the early diagnosis of
neonatal infection. J Pediatr. 1996; 128:570-573.
56. Chiesa C, Panero A, Rossi N, Stegagno M, De Giusti M, Osborn
JF, Pacifico L. Reliability of procalcitonin concentrations for the
diagnosis of sepsis in critically ill neonates. Clin Infect Dis.
1998; 26(3):664-672.
57. Casado-Flores J, Blanco-Quirós A, Asensio J, Arranz E, Garrote
JA, Nieto M. Serum procalcitonin in children with suspected
sepsis: a comparison with C-reactive protein and neutrophil
count. Pediatr Crit Care Med. 2003;4(2):190-195.
2. Simonsen KA, Anderson-Berry AL, Delair SF, Davies DH. Early Onset Neonatal Sepsis. Clin Microbiol Rev. 2014;27(1):21-47.
3. Orfali JL. Sepsis Neonatal. Nuevas estrategias terapéuticas. RevPed Elec. 2004;1(1):25-31.
4. Rodriguez-Weber MA, Lopez-Candiani C, Arredondo-Garcia JL, Gutierrez-Castrellon P, Sanchez-Arriaga F. Morbilidad y mortalidad por sepsis neonatal en un hospital de tercer nivel de atención. Salud pública Méx. 2003;45(2):90-5.
5. Coto GD, Ibáñez A. Protocolo diagnóstico-terapéutico de la sepsis neonatal. Bol Pediatr. 2006;46(Supl 1):125-34.
6. Hospital Infantil de México Federico Gómez. Sepsis Bacteriana del Recién Nacido, No Especificada En: Guías clínicas del Departamento de Neonatología. México: Instituto Nacional de
Salud; 2011. 1-14.
7. Gutiérrez-Muñoz V, Gutiérrez-Muñoz J, Rosas V. Factores de riesgo en sepsis neonatal en un hospital de tercer nivel en la ciudad de México. Rev Esp Med Quir. 2005;10(2):21-4.
8. Coronell W, Perez C, Guerrero C, Bustamante H. Sepsis neonatal.Rev enfermedades infecc ped. 2009;23(90):57-68.
9. Peter G, Cashore WJ. Infections acquired in the nursery: epidemiology and control. En: Remington JS, Klein JO, editores. Infectious diseases of the fetus and newborn infant. Fifth edition. Philadelphia: Saunders; 2001. p. 1264-83.
10. Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS,Wenzel RP. The natural history of the systemic inflammatory response syndrome (SRIS). A prospective study. JAMA.1995;273(2):117-23.
11. Munford R. Sepsis y shock séptico. En: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, editores. Harrison, Principios de Medicina Interna. 14ª Edición. Mc. Graw-Hill, Interamericana; 1998. p. 885–91.
12. Avila Reyes R, Rangel Garcia R, Herrera Pen M, Camacho Ramirez I, Velazquez Quintana NI. Síndrome de Respuesta Inflamatoria Sistémica en recién nacidos menores de 1 500 gramos. Enf Inf Microbiol. 2014;34(3):86-91.
13. Pugin J, Meisner M, Leon A, Gendrel D, Fernandez A. Guide for the cllinical use of procalcitonin in sepsis diagnosis BRAHMS.2004:4-23.
14. Martínez-Leon AF, Arduz-Eguino E, Calderón-López ME. Sensibilidad y especificidad de la procalcitonina y tinción de gram de Buffy coat para el diagnóstico temprano de sepsis en pacientes pediátricos. Gac Med Bol 2011; 34(1):20-24.
15. Connell TG, Rele M, Cowley D, Buttery JP, Curtis N. How reliable is a negative blood culture result? Volume of blood admitted for culture in routine practice in a children’s hospital. Pediatrics 2007; 119(5):891–6.
16. Hedegaard S , Wisborg K, Hvas A. Diagnostic utility of biomarkers for neonatal sepsis - a systematic review. Scand J Infect Dis . 2015; 47(3): 117–124.
17. Chiesa C, Signore F, Assumma M, Buffone E, Pacifico L, Tramontozzi P, et al. Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: Reference intervals and analysis of maternal and perinatal confounders.
Clin Chem 2001; 47(6):1016–22.
18. Auriti C, Fiscarelli E, Ronchetti MP, Argentieri M, Buonocore
G, Prencipe G. Procalcitonin in detecting neonatal nosocomial
sepsis. Arch Dis Child Fetal Neonatal Ed. 2012; 97(5):F368–70.
19. Vouloumanou EK, Plessa E, Karageorgopoulos D, Mantadakis
E, Falagas M. Serum procalcitonin as a diagnostic marker for
neonatal sepsis: a systematic review and meta-analysis. Intensive
Care Med. 2011; 37(5):747–62.
20. Genel F, Atlihan F, Gulez N, kazanci E, Vergin C, Tumay-Terek D,
et al. Evaluation of adhesion molecules CD64, CD11b and CD62L
in neutrophils and monocytes of peripheral blood for early
diagnosis of neonatal infection. World J Pediatr. 2011; 8(1):72–5.
21. Pammi M, Brocklehurst P. Granulocyte transfusions for neonates
with confirmed or suspected sepsis and neutropenia. Cochrane
DB Syst Rev. 2011:CD003956.
22. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal
Infectious Diseases: Evaluation of Neonatal Sepsis. Pediatr Clin
N Am 2013; 60(2):367-389.
23. Stocker M, Fontana M, El Helou S, Wegscheider K and Merger
TM. use of procalcitonin-guided decision-making to shorten
antibiotic therapy in suspected neonatal early-onset sepsis:
prospective randomised intervention trial. Neonatology 2010;
97(2):165-74.
24. Reinhart K, Meisner M, Brunkhorst F. Markers for sepsis
diagnosis: What is useful? Critical Care Clinic. 2006;22(3):503-
519.
25. Islas-Domínguez L, Cardiel-Marmolejo L, Sánchez-Medina O.
Septicemia neonatal temprana. ¿Cuándo iniciar antibióticos?
Rev. mex. pediatr. 2012; 79 (1):12-17.
26. Reimer LG,Wilson ML, Weinstein MP. Update on detection of
bacteremia and fungemia. Clin. microbiol. rev. 1997; 10 (3):444-465.
27. Polin R, et al. Management of Neonates With Suspected or Proven
Early-Onset Bacterial Sepsis. Pediatrics. 2012; 129(5): 1006-1015.
28. Chiesa et al. Diagnosis of Neonatal Sepsis. Clin. chem. 2001; 50
(2): 254-287.
29. Deleon C, Shattuck K, Jain S. Biomarkers of Neonatal Sepsis.
NeoReviews. 2015; 16(5): 297- 308.
30. Arnon S, Litmanovitz I. Diagnostic tests in neonatal sepsis. Curr.
opin. infect. dis. 2008; 21(3):223–227.
31. Ventetuolo C, Levy M. Biomarkers: Diagnosis and Risk
Assessment in Sepsis. Clin. chest med. 2008; 29(4): 591–603.
32. Sierra R. C-Reactive Protein and Procalcitonin as Markers of
Infection, Inflammatory Response, and Sepsis. Clin. pulm. med.
2007; 14 (3): 127-139.
33. Penders J, Thijs C, van den Brandt PA, Kummeling I, Snijders B,
Stelma F, et al. Gut microbiota composition and development of
atopic manifestations in infancy: 354 the KOALA Birth Cohort
Study. Gut. 2007; 56(5):661-7.
34. Neu J. Perinatal and neonatal manipulation of the intestinal microbiome: a note of caution. Nutr. Rev. 2007; 65(6):282-285.
35. Kordek A, Giedrys-Kalemba S, Pawlus B, Podraza W, Czajka R.
Umbilical Cord Blood Serum Procalcitonin Concentration in
the Diagnosis of Early Neonatal Infection. J. perinatol. 2003;
23(2):148–153.
36. Joram M, Bosher C, Demzot S, Loubersac V, Winer N, Roze JC,
et al. Umbilical cord blood procalcitonin and C reactive protein
concentrations as markers for early diagnosis of very early
onset neonatal infection. Arch Dis Child Fetal Neonatal. 2006;
91(1):65-66.
37. Chaouachi s, Marrakchi O, Ben Amida E, Abidi K, Bechir
Z, Abdel Moula S, et al. Apport de la procalcitonine dans le
diagnostic precoce del infection materno-foetale bacterienne.
Elude prospective. Archives de pediatrie. 2011; 18:267-71.
38. Joram N, Muller JB, Denizot S, Orsonneau JL, Caillon J. Rozé
JC, Guen GL. Umbilical cord blood procalcitonin level in early
neonatal infections: a 4-year university hospital cohort study.
Eur Jour of Clin Micr and Infect Dis. 2011; 30:1005-1013.
39. Su H, Chang S-S, Han CM, Wu K-Y, Li MC, Huang CY, et al.
Inflammatory markers in cord blood or maternal serum for
early detection of neonatal sepsis-a systemic review and metaanalysis.
Journal of Perinatology. 2014;34:268-274.
40. Cetin O, Aydin ZD, Verit FF, Zebitay AG, Karaman E, Elasan S,
et al. Is maternal blood Procalcitonin level a reliable predictor
for early onset neonatal sepsis in preterm premature rupture of
membranes?. Gynecol Obstet Invest. 2017;82(2):163-169.
41. Rueda-Salguero OO, Beceiro- Mosqueda J, Barrionuevo-Gonzalez
M, Ripaldo-Crespo MJ, Olivas López De Soria C. Procalcitonina
en sangre de cordon en la valoración del riesgo de sepsis neonatal
precoz. An Pediatr. 2017;87(2):87-94
42. Lim WH, Lien R, Huang YC, Chiang MC, Fu RH, Chu SM, et al.
Prevalence and Pathogen Distribution of Neonatal Sepsis Among
Very-Low-Birth-Weight Infants. Pediatr Neonatol. 2012;53(4):228-
234.
43. Brookfield KF, El-Sayed YY, Chao L, Berger V, Naqvi M,
Butwick AJ. Antenatal corticosteroids for preterm premature
rupture of membranes: single or repeat course?. Am J Perinatol.
2015;32(6):537.544.
44. Bamonde L, Camaño B, Alonso M. La procalcitonina como
marcador de infección. Una revisión desde atención primaria.
Rev Pediatr Aten Primaria. 2002;4:619-630.
45. Roqués V, Fernández C, Gormaz M. Cabezas M.A. Procalcitonina
como marcador de infección neonatal. Acta Pediatrica.
1997;86:209
46. Bartolovic D, Ignjatovic S, Stankovic S, Majkic N. Procalcitonina
and other biomarkers of sepsis in newborn in the Intensive Care
Unit. EJIFCC. 2011 Mar; 22(1): 24–30.
47. Fernández Colomer B, López Sastre J, Coto Cotallo G, Ramos
Aparicio A, Ibáñez Fernández A. Sepsis del recién nacido.
Protocolos Diagnóstico Terapéuticos de la AEP: Neonatología.
2008.
48. Töllner U. Early Diagnosis of septicemia in the Newborn. Clinical
studie and sepsis score. Eur J Pediatr 1982;138:331-337.
49. Hofer N, Miiller W, Resh B. Systemic inflammatory response
síndrome (SIRS) definition and correlation with early-onset
bacterian infection of the newborn. 2010;95(2):151.
50. Gonzalez-Osoyo M, O-Vizcarra M, Garibay-González F.
Identificación de marcadores hematológicos para el diagnóstico
de sepsis neonatal temprana en el Hospital Militar Regional de
Irapuato, Guanajuato. Revi Sanid Milit. [Internet] Nov - Dic 2006.
60(6):390-396. Disponible en: http://www.medigraphic.com/cgibin/
new/resumen.cgi?IDARTICULO=14542
51. Stein M, Schachter-Davidov A, Babai I, Tasher D, Somekh E. The
accuracy of C-reactive proteín, procalcitonin, and s-TREM-I in
the prediction of serious bacterial infection in neonates. Clin.
pediatr. 2015; 54 (5): 439-444.
52. Lewis D B, Wilson C B. Developmental immunology and role of
host defenses in fetal and neonatal susceptibility to infection.
In: Remington JS, Klein JO, eds. Infectious Disease of Fetus,
Newborn, and Infants. 7th ed. Philadelphia, PA: WB Saunders;
2011 : 80-172.
53. Kordek A, Torbé A, Tousky J, Loniewska B, et al. The
determination of procalcitonin concentration in Early-Onset
Neonatal Infection: A valuable test Regardless of Prenatal
Antibiotic Therapy. Clin. Pediatr. 2017;56(4):333-340.
54. Resch B, Gusenleitner W, Muller WD. Procalcitonin and
interleukine 6 in the diagnosis of early-onset sepsis of the
neonate. Acta paediatr. 2003; 92(2):243-245.
55. Gendrel D, Assicot M, Raymond J, Moulin F, Francoual C, Badoual
J, Bohuon C. Procalcitonin as a marker for the early diagnosis of
neonatal infection. J Pediatr. 1996; 128:570-573.
56. Chiesa C, Panero A, Rossi N, Stegagno M, De Giusti M, Osborn
JF, Pacifico L. Reliability of procalcitonin concentrations for the
diagnosis of sepsis in critically ill neonates. Clin Infect Dis.
1998; 26(3):664-672.
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