Early Diagnosis of Neonatal Sepsis: A Review of the Current Methods in Clinical Practice

Abstract

Introduction: The burden of neonatal sepsis continues to be significant, more so in the preterm population. It is quite challenging to make early diagnosis because the early signs of sepsis may be subtle, and resemble those of other non-infectious processes; furthermore, cultures take time and the yield is quite low with wide inter-laboratory variation. Alternative diagnostic tests are simply not accurate enough. The resulting implications of these challenges include prolonged empirical antibiotic therapy for at-risk neonates. An early diagnostic test that is highly accurate will be immensely beneficial in guiding clinicians in neonatal units on commencement of antibiotics and when to stop. This metanalysis assesses the usefulness, reliability, limitations and challenges in clinical practice of some of the tests for the early diagnosis of neonatal sepsis. Methods: A metanalysis of articles on the different methods of diagnosis of neonatal sepsis in clinical practice as well as scientific papers comparing various methods was carried out. Sources include but not limited to Pubmed, HINARI and EMBASE database. Conclusions: Extensive work is being performed to find the ideal test for early diagnosis of neonatal sepsis. Despite numerous studies on acute phase reactants, their use in clinical setting is limited to CRP and PCT to some extent.  There is still need for further research work to find an ideal test for early diagnosis of neonatal sepsis. However, the methodologies and study designs are to be harmonized in order to obtain ideal cut-off acceptable values.