Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis
Background Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS. Methods A syst...
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| Veröffentlicht in: | Pediatric research 2022-08, Vol.92 (2), p.362-372 |
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| creator | Dierikx, Thomas H. van Kaam, Anton H. L. C. de Meij, Tim G. J. de Vries, Ralph Onland, Wes Visser, Douwe H. |
| description | Background
Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS.
Methods
A systematic literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. Studies performing UCBC for the diagnosis of EOS were included.
Results
A total of 1908 articles were screened of which 17 were included. Incidences of positive PBC and UCBC were low in all studies. There was a large heterogeneity in the consistency between positive PBC and UCBC outcomes. PBC had a pooled sensitivity of 20.4% (95% CI 0.0–40.9) and specificity of 100.0% (95% CI 100.0–100.0) compared to 42.6% (95% CI 12.7–72.4%) and 97.8% (95% CI 93.1–100.0) of UCBC for clinical EOS, defined as clinical sepsis regardless of PBC outcomes.
Conclusions
This systematic review shows that, compared to PBC, UCBC has higher sensitivity and comparable specificity for clinical EOS and might be considered as diagnostic test for EOS. Due to the limited number of studies, low incidences of EOS cases, and the imperfect reference standards for EOS, results should be interpreted cautiously.
Impact
This is the first systematic review and meta-analysis investigating the diagnostic test accuracy of umbilical cord blood culture for neonatal early-onset sepsis.
Peripheral blood culture is considered the gold standard for diagnosis of neonatal early-onset sepsis, but its value for this specific diagnosis can be questioned. Umbilical cord blood culture has higher sensitivity and comparable specificity for diagnosis of neonatal early-onset sepsis compared to peripheral blood culture, circumventing the risk for iatrogenic anemia and consequently might be used as a diagnostic tool for early-onset sepsis.
Quality of evidence was regarded as low due to imperfect diagnostic methods of neonatal early-onset sepsis. |
| doi_str_mv | 10.1038/s41390-021-01792-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2590123951</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2719248444</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-b75dc4457ef3c88e7b9f74a2512b588791378a3fb44f21ff70fc5a0d082ef9363</originalsourceid><addsrcrecordid>eNp9kD1LBDEQhoMoeJ7-AauAjU00nyaxE_ELBButQzY7kT2yu2eyq9y_N3qCYGE1MPO8w8yD0DGjZ4wKc14kE5YSyhmhTFtO6A5aMCVqS0q9ixaUCkaEtWYfHZSyopRJZeQCNS9906Uu-ITDmFvcpHFscZjTNGfA3YAHGAc_1TH4nDZkHApMuMC6dOUSe1w2ZYLeT13AGd47-MB-aHEPkyd-8GlTsUO0F30qcPRTl-jl9ub5-p48Pt09XF89kiAUn0ijVRukVBqiCMaAbmzU0nPFeKOM0ZYJbbyIjZSRsxg1jUF52lLDIVpxIZbodLt3nce3Gcrk-q4ESMnXH-biuLKUcWEVq-jJH3Q1zrneWynNLJdGSlkpvqVCHkvJEN06d73PG8eo-9Luttpd1e6-tTtaQ2IbKhUeXiH_rv4n9QnZvIV6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2719248444</pqid></control><display><type>article</type><title>Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis</title><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><source>SpringerLink Journals - AutoHoldings</source><creator>Dierikx, Thomas H. ; van Kaam, Anton H. L. C. ; de Meij, Tim G. J. ; de Vries, Ralph ; Onland, Wes ; Visser, Douwe H.</creator><creatorcontrib>Dierikx, Thomas H. ; van Kaam, Anton H. L. C. ; de Meij, Tim G. J. ; de Vries, Ralph ; Onland, Wes ; Visser, Douwe H.</creatorcontrib><description>Background
Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS.
Methods
A systematic literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. Studies performing UCBC for the diagnosis of EOS were included.
Results
A total of 1908 articles were screened of which 17 were included. Incidences of positive PBC and UCBC were low in all studies. There was a large heterogeneity in the consistency between positive PBC and UCBC outcomes. PBC had a pooled sensitivity of 20.4% (95% CI 0.0–40.9) and specificity of 100.0% (95% CI 100.0–100.0) compared to 42.6% (95% CI 12.7–72.4%) and 97.8% (95% CI 93.1–100.0) of UCBC for clinical EOS, defined as clinical sepsis regardless of PBC outcomes.
Conclusions
This systematic review shows that, compared to PBC, UCBC has higher sensitivity and comparable specificity for clinical EOS and might be considered as diagnostic test for EOS. Due to the limited number of studies, low incidences of EOS cases, and the imperfect reference standards for EOS, results should be interpreted cautiously.
Impact
This is the first systematic review and meta-analysis investigating the diagnostic test accuracy of umbilical cord blood culture for neonatal early-onset sepsis.
Peripheral blood culture is considered the gold standard for diagnosis of neonatal early-onset sepsis, but its value for this specific diagnosis can be questioned. Umbilical cord blood culture has higher sensitivity and comparable specificity for diagnosis of neonatal early-onset sepsis compared to peripheral blood culture, circumventing the risk for iatrogenic anemia and consequently might be used as a diagnostic tool for early-onset sepsis.
Quality of evidence was regarded as low due to imperfect diagnostic methods of neonatal early-onset sepsis.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-021-01792-0</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Diagnostic tests ; Medicine ; Medicine & Public Health ; Meta-analysis ; Pediatric Surgery ; Pediatrics ; Sepsis ; Systematic Review ; Umbilical cord</subject><ispartof>Pediatric research, 2022-08, Vol.92 (2), p.362-372</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-b75dc4457ef3c88e7b9f74a2512b588791378a3fb44f21ff70fc5a0d082ef9363</citedby><cites>FETCH-LOGICAL-c352t-b75dc4457ef3c88e7b9f74a2512b588791378a3fb44f21ff70fc5a0d082ef9363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-021-01792-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-021-01792-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Dierikx, Thomas H.</creatorcontrib><creatorcontrib>van Kaam, Anton H. L. C.</creatorcontrib><creatorcontrib>de Meij, Tim G. J.</creatorcontrib><creatorcontrib>de Vries, Ralph</creatorcontrib><creatorcontrib>Onland, Wes</creatorcontrib><creatorcontrib>Visser, Douwe H.</creatorcontrib><title>Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><description>Background
Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS.
Methods
A systematic literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. Studies performing UCBC for the diagnosis of EOS were included.
Results
A total of 1908 articles were screened of which 17 were included. Incidences of positive PBC and UCBC were low in all studies. There was a large heterogeneity in the consistency between positive PBC and UCBC outcomes. PBC had a pooled sensitivity of 20.4% (95% CI 0.0–40.9) and specificity of 100.0% (95% CI 100.0–100.0) compared to 42.6% (95% CI 12.7–72.4%) and 97.8% (95% CI 93.1–100.0) of UCBC for clinical EOS, defined as clinical sepsis regardless of PBC outcomes.
Conclusions
This systematic review shows that, compared to PBC, UCBC has higher sensitivity and comparable specificity for clinical EOS and might be considered as diagnostic test for EOS. Due to the limited number of studies, low incidences of EOS cases, and the imperfect reference standards for EOS, results should be interpreted cautiously.
Impact
This is the first systematic review and meta-analysis investigating the diagnostic test accuracy of umbilical cord blood culture for neonatal early-onset sepsis.
Peripheral blood culture is considered the gold standard for diagnosis of neonatal early-onset sepsis, but its value for this specific diagnosis can be questioned. Umbilical cord blood culture has higher sensitivity and comparable specificity for diagnosis of neonatal early-onset sepsis compared to peripheral blood culture, circumventing the risk for iatrogenic anemia and consequently might be used as a diagnostic tool for early-onset sepsis.
Quality of evidence was regarded as low due to imperfect diagnostic methods of neonatal early-onset sepsis.</description><subject>Diagnostic tests</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Sepsis</subject><subject>Systematic Review</subject><subject>Umbilical cord</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kD1LBDEQhoMoeJ7-AauAjU00nyaxE_ELBButQzY7kT2yu2eyq9y_N3qCYGE1MPO8w8yD0DGjZ4wKc14kE5YSyhmhTFtO6A5aMCVqS0q9ixaUCkaEtWYfHZSyopRJZeQCNS9906Uu-ITDmFvcpHFscZjTNGfA3YAHGAc_1TH4nDZkHApMuMC6dOUSe1w2ZYLeT13AGd47-MB-aHEPkyd-8GlTsUO0F30qcPRTl-jl9ub5-p48Pt09XF89kiAUn0ijVRukVBqiCMaAbmzU0nPFeKOM0ZYJbbyIjZSRsxg1jUF52lLDIVpxIZbodLt3nce3Gcrk-q4ESMnXH-biuLKUcWEVq-jJH3Q1zrneWynNLJdGSlkpvqVCHkvJEN06d73PG8eo-9Luttpd1e6-tTtaQ2IbKhUeXiH_rv4n9QnZvIV6</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Dierikx, Thomas H.</creator><creator>van Kaam, Anton H. L. C.</creator><creator>de Meij, Tim G. J.</creator><creator>de Vries, Ralph</creator><creator>Onland, Wes</creator><creator>Visser, Douwe H.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20220801</creationdate><title>Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis</title><author>Dierikx, Thomas H. ; van Kaam, Anton H. L. C. ; de Meij, Tim G. J. ; de Vries, Ralph ; Onland, Wes ; Visser, Douwe H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-b75dc4457ef3c88e7b9f74a2512b588791378a3fb44f21ff70fc5a0d082ef9363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Diagnostic tests</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Sepsis</topic><topic>Systematic Review</topic><topic>Umbilical cord</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dierikx, Thomas H.</creatorcontrib><creatorcontrib>van Kaam, Anton H. L. C.</creatorcontrib><creatorcontrib>de Meij, Tim G. J.</creatorcontrib><creatorcontrib>de Vries, Ralph</creatorcontrib><creatorcontrib>Onland, Wes</creatorcontrib><creatorcontrib>Visser, Douwe H.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database (Proquest)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dierikx, Thomas H.</au><au>van Kaam, Anton H. L. C.</au><au>de Meij, Tim G. J.</au><au>de Vries, Ralph</au><au>Onland, Wes</au><au>Visser, Douwe H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><date>2022-08-01</date><risdate>2022</risdate><volume>92</volume><issue>2</issue><spage>362</spage><epage>372</epage><pages>362-372</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
Peripheral blood culture (PBC) is considered the gold standard for diagnosis of neonatal early-onset sepsis (EOS), but its diagnostic value can be questioned. We aimed to systematically asses the diagnostic test accuracy (DTA) of umbilical cord blood culture (UCBC) for EOS.
Methods
A systematic literature search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. Studies performing UCBC for the diagnosis of EOS were included.
Results
A total of 1908 articles were screened of which 17 were included. Incidences of positive PBC and UCBC were low in all studies. There was a large heterogeneity in the consistency between positive PBC and UCBC outcomes. PBC had a pooled sensitivity of 20.4% (95% CI 0.0–40.9) and specificity of 100.0% (95% CI 100.0–100.0) compared to 42.6% (95% CI 12.7–72.4%) and 97.8% (95% CI 93.1–100.0) of UCBC for clinical EOS, defined as clinical sepsis regardless of PBC outcomes.
Conclusions
This systematic review shows that, compared to PBC, UCBC has higher sensitivity and comparable specificity for clinical EOS and might be considered as diagnostic test for EOS. Due to the limited number of studies, low incidences of EOS cases, and the imperfect reference standards for EOS, results should be interpreted cautiously.
Impact
This is the first systematic review and meta-analysis investigating the diagnostic test accuracy of umbilical cord blood culture for neonatal early-onset sepsis.
Peripheral blood culture is considered the gold standard for diagnosis of neonatal early-onset sepsis, but its value for this specific diagnosis can be questioned. Umbilical cord blood culture has higher sensitivity and comparable specificity for diagnosis of neonatal early-onset sepsis compared to peripheral blood culture, circumventing the risk for iatrogenic anemia and consequently might be used as a diagnostic tool for early-onset sepsis.
Quality of evidence was regarded as low due to imperfect diagnostic methods of neonatal early-onset sepsis.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><doi>10.1038/s41390-021-01792-0</doi><tpages>11</tpages></addata></record> |
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| ispartof | Pediatric research, 2022-08, Vol.92 (2), p.362-372 |
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| source | Alma/SFX Local Collection; EZB Electronic Journals Library; SpringerLink Journals - AutoHoldings |
| subjects | Diagnostic tests Medicine Medicine & Public Health Meta-analysis Pediatric Surgery Pediatrics Sepsis Systematic Review Umbilical cord |
| title | Umbilical cord blood culture in neonatal early-onset sepsis: a systematic review and meta-analysis |
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