Biomarkers for the diagnosis of neonatal sepsis and necrotizing enterocolitis: Clinical practice guidelines
Biomarkers for the diagnosis of neonatal sepsis and necrotizing enterocolitis: Clinical practice guidelines
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DOI：
10.1016/j.earlhumdev.2016.12.002
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发表时间：
2017-02-01
影响因子：
2.5
通讯作者：
Bhandari, Vineet
中科院分区：
文献类型：
--
作者：
Gilfillan, Margaret;Bhandari, Vineet
败血症和坏死性小肠结肠炎是新生儿发病率和死亡率的主要因素，特别是在早产儿中。虽然对这两种疾病都有治疗干预措施(例如抗生素)，但一个主要的难题是及早诊断，以便能够及时进行这些干预措施。由于在新生儿败血症或坏死性小肠结肠炎的早期阶段，仅靠临床评估是不可靠的，因此需要找到与这些情况相关的特定生物标志物来提高诊断能力。在识别和管理受影响的新生儿时，最佳使用生物标志物需要在炎症反应的时间线内了解每个标志物的性质。我们建议早期和中期标志物，如中性粒细胞CD64和降钙素原，应该与晚期生物标志物C-反应蛋白联合使用，以获得最大的诊断益处。除了调查其他潜在有用的生物标记物的更多研究外，还表明了在新生儿人群中与抗生素管理相关的决策中评估这些标记物的系列测量的适当动力试验。(C)爱思唯尔爱尔兰有限公司出版的2016年。
Sepsis and necrotizing enterocolitis are major contributors to morbidity and mortality in neonates, especially in those born preterm. While therapeutic interventions are available for both (for e.g. antibiotics), a major dilemma is early diagnosis so that these interventions can be done in a timely manner. As clinical evaluation alone is unreliable in identifying infants in the early stages of neonatal sepsis or necrotizing enterocolitis, there is a need to find specific biomarkers associated with these conditions to improve diagnostic capabilities. Optimal use of biomarkers in the identification and management of affected neonates requires an understanding of the properties of each marker within the timeline of the inflammatory response. We propose that early-and mid-phase markers such as neutrophil CD64 and procalcitonin should be combined with the late-phase biomarker C-reactive protein for maximal diagnostic benefit. Appropriately powered trials evaluating the serial measurements of these markers in decisions related to antibiotic stewardship in the neonatal population are indicated, in addition to more studies investigating other potentially useful biomarkers. (C) 2016 Published by Elsevier Ireland Ltd.