Predictors of early-onset neonatal infections (review)
- 作者: Aleksandrovich Y.S.1, Ivanov D.O.1, Pavlovskaya E.Y.1,2, Pshenisnov K.V.1
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隶属关系:
- Saint Petersburg State Pediatric Medical University
- St. Nicholas the Children’s City Hospital No. 17
- 期: 卷 14, 编号 6 (2023)
- 页面: 79-87
- 栏目: Reviews
- URL: https://journals.eco-vector.com/pediatr/article/view/626896
- DOI: https://doi.org/10.17816/PED626896
- ID: 626896
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详细
Infections of the early neonatal period and neonatal sepsis are the most common cause of critical condition, various complications and unfavorable outcome of the disease, both in the early and distant periods, but there are currently no reliable criteria for diagnosis, which makes it difficult to recognize the infectious process early. Based on the results of numerous studies, it was found that the clinical blood test has extremely low clinical value for the diagnosis of infections and early neonatal sepsis. It was found that the concentration of C-reactive protein in the blood rises 10–12 hours after the appearance of the first clinical manifestations of infection and peaks 48 hours later. An increase in C-reactive protein to 20 mg/L 48 hours after birth is possible even in newborns without infection, so its use as a marker of infections of the early neonatal period is very difficult. The threshold for C-reactive protein concentration in the first days of life is 10 mg/L. Premature babies have lower C-reactive protein values compared to full-term newborns. Increasing the concentration of procalcitonin, as well as C-reactive protein, immediately after birth is physiological, which limits their diagnostic value in the first 2–4 days of life. The procalcitonin concentration study is more justified for making an informed decision to discontinue antibacterial therapy. Presepsin is one of the earliest markers of a severe course of infections in newborns, since its concentration does not depend on the term of gestation. The level of N-terminal pro-BNP can be used as a marker of cardiovascular dysfunction, an increase in its level is associated with the severity of the infectious process and fatal outcome. A universal marker of infections of the early neonatal period and sepsis in newborns is currently absent, which indicates the need for a thorough assessment of all available clinical and laboratory tests over time.
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作者简介
Yurii Aleksandrovich
Saint Petersburg State Pediatric Medical University
编辑信件的主要联系方式.
Email: jalex1963@mail.ru
ORCID iD: 0000-0002-2131-4813
SPIN 代码: 2225-1630
MD, PhD, Dr. Sci. (Medicine), Professor, Head of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education
俄罗斯联邦, Saint PetersburgDmitry Ivanov
Saint Petersburg State Pediatric Medical University
Email: spb@gpma.ru
ORCID iD: 0000-0002-0060-4168
SPIN 代码: 4437-9626
MD, PhD, Dr. Sci. (Medicine), Professor, Chief Freelance Neonatologist of the Ministry of Health of Russia, Rector, Head of the Department of Neonatology with courses of Neurology and Obstetrics and Gynecology, Postgraduate Education
俄罗斯联邦, Saint PetersburgEkaterina Pavlovskaya
Saint Petersburg State Pediatric Medical University; St. Nicholas the Children’s City Hospital No. 17
Email: l.pavlovskaya@yandex.ru
ORCID iD: 0000-0001-9960-7141
SPIN 代码: 4308-6025
anesthesiologist and intensive care physician; Applicant of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education
俄罗斯联邦, Saint Petersburg; Saint PetersburgKonstantin Pshenisnov
Saint Petersburg State Pediatric Medical University
Email: Psh_K@mail.ru
ORCID iD: 0000-0003-1113-5296
SPIN 代码: 8423-4294
MD, PhD, Dr. Sci. (Medicine), Associate Professor, Professor of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education
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