title: Evaluation of recent methods versus conventional methods for diagnosis of early-onset neonatal sepsis.
abstract: BACKGROUND
  Hospital-acquired infections continue to be a major public health problem, especially among neonates. Large proportions of infants are admitted to neonatal intensive care units (NICUs) and receive potent systemic antibiotics while the diagnostic work-up is still in progress. This study aimed to evaluate the recent methods for diagnosing neonatal sepsis (NS) and compare them to conventional diagnostic work-up.
  
  
  METHODS
  The study included 100 neonates divided into three groups: proven early-onset NS, clinical early-onset NS, and negative infectious status. Bacterial DNA was detected in the blood by broad-range 16S rDNA polymerase chain reaction (PCR). Markers for diagnosis of bacterial infection, which includedprocalcitonin (PCT), interleukin-6 (IL-6), and highly sensitive C-reactive protein (hs-CRP), were measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Blood culture was positive in 25 cases, while PCR for 16S rDNA was positive in 32 cases. Hs-CRP was significantly elevated in 30 patients in group 1, 35 patients in group 2, and 8 patients in group 3. IL-6 was significantly elevated in 28 patients in group 1, 24 patients in group 2, and 9 patients in group 3. PCT was found to be significantly elevated in 29 patients in group 1, 31 patients in group 2, and 2 patients in group 3.
  
  
  CONCLUSIONS
  The16S rDNA PCR assay was more sensitive than blood culture. The combination of markers (hs-CRP, PCT, and IL-6) is better than single markers to diagnose sepsis. PCT had greater diagnostic value than did hs-CRP and IL-6, while IL-6 was better for diagnosis of neonatal infection.
authors.affiliation: College of Medicine Taif University, Neonatal Intensive Care Unit King Abdulaziz Specialist Hospital, Taif, Saudi Arabia. dremadeed@yahoo.com.
authors.forename: Ali Kh
authors.initials: AKh
authors.lastname: Al-Zahrani
authors.forename: Mabrouk M
authors.initials: MM
authors.lastname: Ghonaim
authors.forename: Yousri M
authors.initials: YM
authors.lastname: Hussein
authors.forename: Emad M
authors.initials: EM
authors.lastname: Eed
authors.forename: Amany S
authors.initials: AS
authors.lastname: Khalifa
authors.forename: Lalia S
authors.initials: LS
authors.lastname: Dorgham
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques / Q000379:methods*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D003428:Cross Infection / Q000175:diagnosis*; D004269:DNA, Bacterial / Q000097:blood; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D016133:Polymerase Chain Reaction; D011498:Protein Precursors / Q000097:blood; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
chemical_list: D004269:DNA, Bacterial; D004275:DNA, Ribosomal; C508600:IL6 protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D012336:RNA, Ribosomal, 16S; D002116:Calcitonin; D002097:C-Reactive Protein