Abstract | BACKGROUND:
Biomarkers may enhance diagnostic capability for common paediatric infections, especially in low- and middle-income countries (LMICs) where standard diagnostic modalities are frequently unavailable, but disease burden is high. A comprehensive understanding of the diagnostic capability of commonly available biomarkers for neonatal sepsis in LMICs is lacking. Our objective was to systematically review evidence on biomarkers to understand their diagnostic performance for neonatal sepsis in LMICs. METHODS: We conducted a systematic review and meta-analysis of studies published in English, Spanish, French, German, Dutch, and Arabic reporting the diagnostic performance of C reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC) and procalcitonin (PCT) for neonatal sepsis. We calculated pooled test characteristics and the area under the curve (AUC) for each biomarker compared with the reference standards blood culture or clinical sepsis defined by each article. RESULTS: Of 6570 studies related to biomarkers in children, 134 met inclusion criteria and included 23 179 neonates. There were 80 (59.7%) studies conducted in LMICs. CRP of ≥60 mg/L (AUC 0.87, 95% CI 0.76 to 0.91) among 1339 neonates and PCT of ≥0.5 ng/mL (AUC 0.87, 95% CI 0.70 to 0.92) among 617 neonates demonstrated the greatest discriminatory value for the diagnosis of neonatal sepsis using blood culture as the reference standard in LMICs. CONCLUSIONS: PROSPERO REGISTRATION NUMBER: CRD42020188680.
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Authors | Chris A Rees, Jamie Lim, Adrianna L Westbrook, Rachelle El Helou, Alexis Schmid, Julia Rubin-Smith, Kyra Shreeve, Chloe Rotman, Sindu Govindapillai, Kate Dorney, Michelle Niescierenko |
Journal | BMJ paediatrics open
(BMJ Paediatr Open)
Vol. 7
Issue 1
(01 2023)
ISSN: 2399-9772 [Electronic] England |
PMID | 36649385
(Publication Type: Meta-Analysis, Systematic Review, Journal Article)
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Copyright | © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
- Biomarkers
- C-Reactive Protein
- Calcitonin
- Procalcitonin
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Topics |
- Humans
- Infant, Newborn
- Biomarkers
- C-Reactive Protein
(analysis)
- Calcitonin
- Developing Countries
- Neonatal Sepsis
(diagnosis)
- Procalcitonin
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