Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis
Early onset neonatal sepsis is a significant contributor to neonatal morbidity and mortality. Although blood cultures remain the diagnostic gold standard, they detect pathogens in only a minority of suspected cases. This study compared the accuracy of blood cultures with a rapid multiplex PCR test....
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/11/1809 |
| _version_ | 1797459655281082368 |
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| author | Anja Stein Daniel Soukup Peter-Michael Rath Ursula Felderhoff-Müser |
| author_facet | Anja Stein Daniel Soukup Peter-Michael Rath Ursula Felderhoff-Müser |
| author_sort | Anja Stein |
| collection | DOAJ |
| description | Early onset neonatal sepsis is a significant contributor to neonatal morbidity and mortality. Although blood cultures remain the diagnostic gold standard, they detect pathogens in only a minority of suspected cases. This study compared the accuracy of blood cultures with a rapid multiplex PCR test. Newborns at risk of neonatal sepsis were prospectively screened as recommended per national guidelines. Evaluations included laboratory parameters (CrP, IL6, differential blood count), blood culture, and a molecular multiplex PCR test (ROCHE LightCycler SeptiFast<sup>®</sup>) identifying 20 common microbial agents. Blood samples were taken simultaneously from umbilical cord or venous sources on the first day of life. Of 229 infants included, 69% were born preterm. Blood culture and multiplex PCR sensitivity were 7.4% and 14.8%, respectively. Specificity, negative and positive predictive values between methods showed no significant variance, although multiplex PCR had more false positives due to contamination. The limited sensitivity of blood cultures for early onset neonatal sepsis is concerning. Despite quicker results, multiplex PCR does not enhance diagnostic accuracy or antibiotic therapy guidance, thus it cannot be recommended for this indication. |
| first_indexed | 2024-03-09T16:55:29Z |
| format | Article |
| id | doaj.art-2a07998e7af344c6b33c1433e3035c8d |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T16:55:29Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-2a07998e7af344c6b33c1433e3035c8d2023-11-24T14:35:57ZengMDPI AGChildren2227-90672023-11-011011180910.3390/children10111809Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal SepsisAnja Stein0Daniel Soukup1Peter-Michael Rath2Ursula Felderhoff-Müser3Department of Pediatrics I, Neonatology and Experimental Perinatal Neurosciences, Center for Translational and Behavioral Neuroscience, CTNBS, University Hospital Essen, Faculty of Medicine, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Pediatrics I, Neonatology and Experimental Perinatal Neurosciences, Center for Translational and Behavioral Neuroscience, CTNBS, University Hospital Essen, Faculty of Medicine, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyInstitute for Medical Microbiology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Pediatrics I, Neonatology and Experimental Perinatal Neurosciences, Center for Translational and Behavioral Neuroscience, CTNBS, University Hospital Essen, Faculty of Medicine, University Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyEarly onset neonatal sepsis is a significant contributor to neonatal morbidity and mortality. Although blood cultures remain the diagnostic gold standard, they detect pathogens in only a minority of suspected cases. This study compared the accuracy of blood cultures with a rapid multiplex PCR test. Newborns at risk of neonatal sepsis were prospectively screened as recommended per national guidelines. Evaluations included laboratory parameters (CrP, IL6, differential blood count), blood culture, and a molecular multiplex PCR test (ROCHE LightCycler SeptiFast<sup>®</sup>) identifying 20 common microbial agents. Blood samples were taken simultaneously from umbilical cord or venous sources on the first day of life. Of 229 infants included, 69% were born preterm. Blood culture and multiplex PCR sensitivity were 7.4% and 14.8%, respectively. Specificity, negative and positive predictive values between methods showed no significant variance, although multiplex PCR had more false positives due to contamination. The limited sensitivity of blood cultures for early onset neonatal sepsis is concerning. Despite quicker results, multiplex PCR does not enhance diagnostic accuracy or antibiotic therapy guidance, thus it cannot be recommended for this indication.https://www.mdpi.com/2227-9067/10/11/1809neonatal sepsisearly onset sepsismultiplex PCRinfectionneonatediagnosis |
| spellingShingle | Anja Stein Daniel Soukup Peter-Michael Rath Ursula Felderhoff-Müser Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis Children neonatal sepsis early onset sepsis multiplex PCR infection neonate diagnosis |
| title | Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis |
| title_full | Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis |
| title_fullStr | Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis |
| title_full_unstemmed | Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis |
| title_short | Diagnostic Accuracy of Multiplex Polymerase Chain Reaction in Early Onset Neonatal Sepsis |
| title_sort | diagnostic accuracy of multiplex polymerase chain reaction in early onset neonatal sepsis |
| topic | neonatal sepsis early onset sepsis multiplex PCR infection neonate diagnosis |
| url | https://www.mdpi.com/2227-9067/10/11/1809 |
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