{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:12:53Z","timestamp":1753877573327,"version":"3.41.2"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","award":["848015005"],"award-info":[{"award-number":["848015005"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Sophia Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Discriminating noninfected from infected neonatal cases remains challenging, and subsequently many neonates are treated with antibiotics in the first week of life. We aimed to study the additional value of a targeted polymerase chain reaction (PCR) for group B streptococcus (GBS) and Escherichia coli on leftover blood culture media from term and near-term neonates with probable early-onset sepsis (EOS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Leftover blood culture material from neonates participating in the RAIN study was stored after 5 days of incubation. The RAIN study evaluated intravenous-oral antibiotic switch in probable bacterial infection, defined as risk factors and\/or clinical signs and elevated inflammatory parameters but negative blood culture results. We applied 2 targeted PCRs for GBS and E coli, the main pathogens in EOS, and analyzed the samples batchwise in triplicate for each PCR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>PCR was performed in triplicate on blood culture media from 284 neonates. In 23 neonates, the PCR result was positive (3 cycle threshold values &amp;lt;37) for GBS (n = 1) or E coli (n = 22). Inflammatory parameters did not discriminate for positive PCR result, nor did risk factors for sepsis, such as maternal GBS status and prolonged rupture of membranes. However, 96% of neonates with a positive PCR result were born vaginally vs 74% in the PCR-negative group (P = .05); furthermore, 96% vs 81% (P = .21) of neonates had clinical symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Blood culture\u2013negative \u201cprobable\u201d EOS in neonates is accompanied by an 8% rate of PCR positivity, suggesting low-grade bacteriemia after birth with yet unclear clinical consequences. Further research should focus on how PCR can contribute to more targeted antibiotic use of neonates, specifically in those highly suspected of infection but in the absence of a positive blood culture result.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae681","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T11:50:53Z","timestamp":1732017053000},"source":"Crossref","is-referenced-by-count":0,"title":["Yield of Targeted Polymerase Chain Reaction in Probable Early-Onset Sepsis: A Prospective Cohort Study in Term and Near-Term Neonates With Negative Blood Culture Results"],"prefix":"10.1093","volume":"11","author":[{"given":"Fleur M","family":"Keij","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Neonatal and Pediatric Intensive Care, Erasmus MC- Sophia Children's Hospital , Rotterdam ,","place":["the Netherlands"]},{"name":"Department of Pediatrics, Franciscus Gasthuis & Vlietland , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corn\u00e9 H W","family":"Klaassen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9 F","family":"Kornelisse","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Neonatal and Pediatric Intensive Care, Erasmus MC- Sophia Children's Hospital , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireille","family":"van Westreenen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0228-5375","authenticated-orcid":false,"given":"Gerdien A","family":"Tramper-Stranders","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Neonatal and Pediatric Intensive Care, Erasmus MC- Sophia Children's Hospital , Rotterdam ,","place":["the Netherlands"]},{"name":"Department of Pediatrics, Franciscus Gasthuis & Vlietland , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"2024122308161837000_ofae681-B1","doi-asserted-by":"crossref","first-page":"e200593","DOI":"10.1001\/jamapediatrics.2020.0593","article-title":"Early-onset neonatal sepsis 2015 to 2017, the rise of Escherichia coli, and the need for novel prevention strategies","volume":"174","author":"Stoll","year":"2020","journal-title":"JAMA Pediatr"},{"key":"2024122308161837000_ofae681-B2","doi-asserted-by":"crossref","first-page":"e2243691","DOI":"10.1001\/jamanetworkopen.2022.43691","article-title":"Analysis of antibiotic exposure and early-onset neonatal sepsis in Europe, North America, and Australia","volume":"5","author":"Giannoni","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2024122308161837000_ofae681-B3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.cmi.2023.02.021","article-title":"Game changer or gimmick: inflammatory markers to guide antibiotic treatment decisions in neonatal early-onset sepsis","volume":"30","author":"Stocker","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"2024122308161837000_ofae681-B4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1038\/s41467-020-20495-4","article-title":"Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization","volume":"12","author":"Uzan-Yulzari","year":"2021","journal-title":"Nat Commun"},{"key":"2024122308161837000_ofae681-B5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s40168-017-0313-3","article-title":"Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates","volume":"5","author":"Nogacka","year":"2017","journal-title":"Microbiome"},{"key":"2024122308161837000_ofae681-B6","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1542\/peds.2006-0440","article-title":"How reliable is a negative blood culture result? 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