Using newborn screening analytes to identify cases of neonatal sepsis

被引:21
|
作者
Fell, Deshayne B. [1 ,2 ,3 ]
Hawken, Steven [1 ,3 ,4 ]
Wong, Coralie A. [3 ]
Wilson, Lindsay A. [4 ]
Murphy, Malia S. Q. [4 ]
Chakraborty, Pranesh [5 ,6 ]
Lacaze-Masmonteil, Thierry [7 ]
Potter, Beth K. [1 ,3 ]
Wilson, Kumanan [3 ,4 ,8 ]
机构
[1] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada
[2] Childrens Hosp Eastern Ontario, Res Inst, Ottawa, ON, Canada
[3] Univ Ottawa, ICES, Ottawa, ON, Canada
[4] Ottawa Hosp, Clin Epidemiol Program, Res Inst, Ottawa, ON, Canada
[5] Univ Ottawa, Dept Pediat, Ottawa, ON, Canada
[6] Childrens Hosp Eastern Ontario, NSO, Ottawa, ON, Canada
[7] Univ Calgary, Dept Pediat, Calgary, AB, Canada
[8] Univ Ottawa, Dept Med, Ottawa, ON, Canada
来源
SCIENTIFIC REPORTS | 2017年 / 7卷
基金
比尔及梅琳达.盖茨基金会;
关键词
CATABOLIC RESPONSE; SEPTIC SHOCK; DIAGNOSIS; METABOLOMICS; STRESS; BIOMARKERS; CARNITINE; CHILDREN; BURDEN;
D O I
10.1038/s41598-017-18371-1
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Neonatal sepsis is associated with high mortality and morbidity, yet challenges with available diagnostic approaches can lead to delays in therapy. Our study assessed whether newborn screening analytes could be utilized to identify associations with neonatal sepsis. We linked a newborn screening registry with health databases to identify cases of sepsis among infants born in Ontario from 2010-2015. Correlations between sepsis and screening analytes were examined within three gestational age groups (early preterm: <34 weeks; late preterm: 34-36 weeks; term: >= 37 weeks), using multivariable logistic regression models. We started with a model containing only clinical factors, then added groups of screening analytes. Among 793,128 infants, 4,794 were diagnosed with sepsis during the neonatal period. Clinical variables alone or in combination with hemoglobin values were not strongly predictive of neonatal sepsis among infants born at term or late preterm. However, model fit improved considerably after adding markers of thyroid and adrenal function, acyl-carnitines, and amino acids. Among infants born at early preterm gestation, neither clinical variables alone nor models incorporating screening analytes adequately predicted neonatal sepsis. The combination of clinical variables and newborn screening analytes may have utility in identifying term or late preterm infants at risk for neonatal sepsis.
引用
收藏
页数:10
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