Diagnostic criteria for early onset neonatal sepsis

master's thesis

• Title (croatian): Dijagnostički kriteriji za ranu novorođenačku sepsu
• Author: Branimir Klobučar
• Mentor: Boris Filipović-Grčić (mentor)
• Committee member: Boris Filipović-Grčić (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Ruža Grizelj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Neonatal sepsis is one of the leading causes of neonatal mortality worldwide. Unlike in the adult population, there is a large variability in the clinical picture and therefore the difficulty to recognize and diagnose neonatal sepsis. In addition to this, there is a lack of clear diagnostic criteria that would aide clinicians in diagnosis and rapid treatment of sepsis. There has been much ongoing research in this area without any striking success. Neonatal sepsis can be divided into different categories based on the age of disease onset. Early onset neonatal sepsis occurs in the first 72 hours of the child’s life and is associated with various risk factors and physiological differences when compared to other age groups. The risk factors may be related to the mother, the child or the process of delivery. Early onset neonatal sepsis also has a specific set of pathogens that are most likely to cause disease. The two most common pathogens, E. coli and Group B streptococcus, have a tendency to exploit the neonates immature immune system resulting in possible complications. Several components of the neonates’ physiological inflammatory response have been researched for their value in diagnosis. The current evidence for C-reactive protein, procalcitonin, interleukin-6 and several other inflammatory reactants have shown variable results. The lack of a clear biomarker that would consistently confirm or exclude the diagnosis of neonatal sepsis continues to elude us. The continued exploration into the various markers and their combinations still needs to be researched so that a list of criteria can be developed in order to reduce the devastating results of the disease.

Abstract (croatian)

Sepsa je jedan od vodećih uzroka smrtnosti novorođenčadi širom svijeta. U usporedbi s odraslom populacijom, u novorođenčadi je klinička slika sepse nespecifična i šarolika. Zbog toga je rano prepoznavanje novorođenačke sepse uvelike otežano. Pored toga, nedostaju jasni dijagnostički kriteriji koji bi omogućili ispravnu i brzu dijagnozu sepse. Ovaj problem predmetom je konstantnog istraživanja, zasad bez nekog znatnijeg uspjeha. Novorođenačka sepsa može se podijeliti u različite kategorije ovisno o vremenu pojavljivanja bolesti. Rana novorođenačka sepsa javlja se u prvih sedamdeset i dva sata života i povezana je s različitim rizičnim čimbenicima i razlikuje se od sepse u drugim dobnim skupinama. Čimbenici rizika mogu biti povezani s majkom, novorođenčetom ili s procesom rađanja. Rana novorođenačka sepsa također ima specifičan skup patogena kao najvjerojatnije uzročnike. Dva patogena, Escherichia coli i Streptococcus B skupine, najčešći su uzročnici rane novorođenačke sepse. Neke osobitosti upalne reakcije novorođenčadi istraživane su s ciljem vrednovanja u postavljanju dijagnoze. Istraživanja o dijagnostičkoj vrijednosti C-reaktivnog proteina, prokalcitonina, interleukina-6 i nekoliko drugih upalnih reaktanata pokazala su različite rezultate. Još uvijek nije nađen biljeg koji bi dosljedno potvrdio ili isključio dijagnozu sepse u novorođenčadi. Neophodno je nastaviti istraživanja te pronaći dijagnostičke alate čime bi se omogućilo pouzdano i pravovremeno postavljanje dijagnoze ove opake bolesti.

• Keywords: sepsis; early-onset sepsis; newborn; diagnosis
• Keywords (croatian): sepsa; rana novorođenčka sepsa; novorođenče; dijagnoza
• Language: english
• URN:NBN: urn:nbn:hr:105:435381
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-04-24 08:12:36