ArticleCritical care (London, England)2021
Association of inflammatory biomarkers with subsequent clinical course in suspected late onset sepsis in preterm neonates.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Heart Rate Characteristics Monitoring for Late-Onset Sepsis in Preterm Infants: A Systematic Review.Neonatology · 2023Pooled it
- Machine-learning based prediction of prognostic risk factors in patients with invasive candidiasis infection and bacterial bloodstream infection: a singled centered retrospective study.BMC infectious diseases · 2022Trial
- Heterogeneity of Critical Organ Dysfunction During Late-Onset Bacteremia in Preterm Infants.JAMA network open · 2026Observational
- The diagnostic accuracy of presepsin for late-onset neonatal sepsis: a multicenter prospective cohort study.Pediatric research · 2025Observational
- Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis.Clinical and experimental pediatrics · 2025Article
- Retrospective Evaluation of Empiric Vancomycin Therapy for Infectious Workups in Relation to Methicillin-ResistantThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Biomarker Potential of Interleukin-6 in Differentiating Necrotizing Enterocolitis from Late-Onset Sepsis in Neonates Born Preterm.Journal of pediatrics. Clinical practice · 2025Article
- Phase-specific mortality risk of serum lactate thresholds in very low birth weight infants with late-onset sepsis: a retrospective cohort study.Frontiers in medicine · 2025Article
- Enhanced predictive accuracy of mortality in VLBW infants with late-onset sepsis through a time-specific nomogram.Frontiers in public health · 2025Article
- Mathematical model of the inflammatory response to acute and prolonged lipopolysaccharide exposure in humans.NPJ systems biology and applications · 2024Article
- Association between tumor necrosis factor-α gene polymorphism and interleukin-6 level with mortality of neonatal sepsis.Narra J · 2024Article
- Predictive Role of Maternal Laboratory Parameters and Inflammatory Scores in Determining Systemic Inflammatory Response Syndrome in Newborns at Birth.Journal of personalized medicine · 2024Article
- Reliability of IL-6 Alone and in Combination for Diagnosis of Late Onset Sepsis: A Systematic Review.Children (Basel, Switzerland) · 2024Review
- The monocyte-derived cytokine response in whole blood from preterm newborns against sepsis-related bacteria is similar to term newborns and adults.Frontiers in immunology · 2024Article
- Inflammatory biomarkers and physiomarkers of late-onset sepsis and necrotizing enterocolitis in premature infants.Frontiers in pediatrics · 2024Article
- Inflammation, sepsis severity and neurodevelopmental outcomes of late-onset sepsis in preterm neonates.Pediatric research · 2023Article
- Association of Positive Bacterial Cultures Obtained from the Throat, Anus, Ear, Bronchi and Blood in Very-Low-Birth-Weight Premature Infants with Severe Retinopathy of Prematurity-Own Observations.Journal of clinical medicine · 2023Article
- Blood Biomarkers of Neonatal Sepsis with Special Emphasis on the Monocyte Distribution Width Value as an Early Sepsis Index.Medicina (Kaunas, Lithuania) · 2023Article
- The Role of Coagulase-Negative Staphylococci Biofilms on Late-Onset Sepsis: Current Challenges and Emerging Diagnostics and Therapies.Antibiotics (Basel, Switzerland) · 2023Review
- The role of human milk feeds on inotrope use in newborn infants with sepsis.Frontiers in pediatrics · 2023Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSepsis is a major health issue in preterm infants. Biomarkers are used to diagnose and monitor patients with sepsis, but C-reactive protein (CRP) is proven not predictive at onset of late onset neonatal sepsis (LONS) diagnosis. The aim of this study was to evaluate the association of interleukin-6(IL-6), procalcitonin (PCT) and CRP with subsequent sepsis severity and mortality in preterm infants suspected of late onset neonatal sepsis.
methodsThe study was conducted at the Erasmus University Medical Center-Sophia Children's Hospital Rotterdam. Patient data from January 2018 until October 2019 were reviewed for all preterm neonates born with a gestational age below 32 weeks with signs and symptoms suggestive of systemic infection, in whom blood was taken for blood culture and for inflammatory biomarkers determinations. Plasma IL-6 and PCT were assessed next to CRP at the moment of suspicion. We assessed the association with 7-day mortality and sepsis severity (neonatal sequential organ failure assessment (nSOFA) score, need for inotropic support, invasive ventilation and thrombocytopenia).
resultsA total of 480 suspected late onset neonatal sepsis episodes in 208 preterm neonates (gestational age < 32 weeks) were retrospectively analyzed, of which 143 episodes were classified as sepsis (29.8%), with 56 (11.7%) cases of culture negative, 63 (13.1%) cases of gram-positive and 24(5.0%) cases of gram-negative sepsis. A total of 24 (5.0%) sepsis episodes resulted in death within 7 days after suspicion of LONS. Both IL-6 (adjusted hazard ratio (aHR): 2.28; 95% CI 1.64-3.16; p < 0.001) and PCT (aHR: 2.91; 95% CI 1.70-5.00; p < 0.001) levels were associated with 7-day mortality; however, CRP levels were not significantly correlated with 7-day mortality (aHR: 1.16; 95% CI (0.68-2.00; p = 0.56). Log IL-6, log PCT and log CRP levels were all significantly correlated with the need for inotropic support.
conclusionsOur findings show that serum IL-6 and PCT levels at moment of suspected late onset neonatal sepsis offer valuable information about sepsis severity and mortality risk in infants born below 32 weeks of gestation. The discriminative value was superior to that of CRP. Determining these biomarkers in suspected sepsis may help identify patients with imminent severe sepsis, who may require more intensive monitoring and therapy.
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