Preterm births are becoming more common worldwide, leading to an increase in the complications of prematurity. Preterm babies are specifically at risk of infection, defined as late onset sepsis after the third day of life. Ideally, infection should be prevented but if this is not possible rapid and accurate detection is necessary so that treatment can be started early_ Symptoms of infection in term and preterm infants are non-specific. Current methods of diagnosis are dependent on culturing organisms in blood, but this can be problematic and diagnostic performance in neonates is not good. Alternative methods may prove to be more efficient. The aim of this study was to determine if molecular methods can improve the diagnosis of infection in neonates. Success of the molecular assay was judged based on comparison with blood culture and CRP. ability to quantify bacterial copy number and to specifically identify pathogens. Infants whom clinicians thought were infected had additional blood sampled at the time of routine investigations for infection. Clinical and routine laboratory data were also recorded. Molecular analysis of the samples was performed using a reverse transcriptase real~ time PCR 16S rRNA assay. 16S rRNA is a universal sequence present in all bacteria. Infants were judged to be infected based on a previously validated culture~ independent clinical scoring system. Eighty four infants were included in the analysis. 16S reran proved to be more sensitive and specific than blood culture and CRP. The assay could quantify the number of bacteria present in the infection ("bacterial load"). A number of less common bacteria and Human Parechovirus were identified and further correlation is required to determine the pathogenicity of these organisms . In summary. molecular methods can enhance the diagnosis of late onset neonatal sepsis, provide quantitative information, on bacterial load and provide insights into the nature of bacteria causing the disease process.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:601144 |
| Date | January 2013 |
| Creators | Davis, Jonathan |
| Publisher | Queen's University Belfast |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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