Biomarkers in Diagnosing Late-onset Neonatal Sepsis
Adem POLAT, Turan TUNÇ, Buket KILIÇASLAN, Hacer ERGİN, Dilek DİLLİ, Ramazan ÖZDEMİR, Emrah CAN, Sinan USLU
Late onset bacterial sepsis of neonates (LOS) is a highly mortal disease, although it is still a diagnostic challenge. Unfortunately a gold standard diagnostic test has yet to be described. In the current study it was aimed to investigate the diagnostic value of sTREM-1, PTX-3 and Pro-ADM in LOS and compare with currently used biomarkers.
In this multi-centric prospective study, patients were recruited from different NICUs among Turkey. Neonates, hospitalized with a suspicion of LOS were included. Patients were divided into three groups as; proven sepsis, clinical sepsis and control group regarding clinical and laboratory findings. The primary outcome was to evaluate any difference between groups regarding the diagnostic value of the biomarkers.
The study consisted of 192 patients; proven sepsis (n=86), clinical sepsis (n=60) and control (n=46) groups. Mean CRP (P<0.001), mean WBC (P=0.015) and mean procalcitonin (PCT) (P=0.004) levels were significantly higher and mean platelet level was significantly lower (P<0.001) in clinical sepsis and proven sepsis groups. No statistical difference was present between groups regarding mean PTX-3 (P = 0.189), Pro-ADM (P = 0.536) and sTREM-1 (P = 0.091) levels.
Serum PTX-3, Pro-ADM and sTREM-1 levels did not indicate LOS diagnosis. Regarding previous studies their relation to correlation with disease progression may make more sense. High CRP and PCT and low platelet levels were the most significant biomarkers for detecting LOS in our cohort.