Can Endocan Predict Late-Onset Neonatal Sepsis?

2018 ◽  
Vol 14 (03) ◽  
pp. 096-102 ◽  
Author(s):  
Cuneyt Tayman ◽  
Nilufer Okur ◽  
Utku Serkant ◽  
Ufuk Cakir ◽  
Halit Halil ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Leukocyte Count ◽  
Clinical Findings ◽  
Sepsis Group ◽  
Suspected Sepsis ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Significant Difference

Objective Endocan, a proteoglycan secreted by endothelial cells, plays a role in the pathogenesis of sepsis. Endocan is an effective diagnostic and prognostic biomarker of sepsis in adult patients. We evaluate the utility of endocan as a new biomarker in the recognition of late-onset neonatal sepsis (LOS) in preterm infants. Methods This study included preterm infants at gestational age ≤ 32 weeks diagnosed with LOS. Sepsis was diagnosed in the presence of three or more clinical findings plus significant elevation of C-reactive protein (CRP) or interleukin 6 (IL-6) levels. Blood samples were obtained to determine leukocyte count, CRP, IL-6, and endocan levels immediately after the sepsis diagnosis and on the 3rd and 7th day after diagnosis. Results A total of 102 preterm infants, 52 with LOS (21 proven, 31 suspected sepsis) and 50 controls, were included in the study. Mean leukocyte count, serum CRP, IL-6, and endocan levels were significantly higher in the LOS group compared with healthy controls (p < 0.001) at enrolment. Serial measurements showed no significant difference in CRP and IL-6 levels between the proven and suspected sepsis groups, while endocan levels were significantly higher at enrolment and on day 7 in the proven sepsis group (p = 0.003 and p = 0.01, respectively). The endocan levels of preterm infants who died were significantly higher at all time points (p < 0.001, p = 0.001, and p = 0.004, respectively). Conclusion Endocan is an effective, reliable, and promising new biomarker for detecting LOS in preterm infants.

scholarly journals cfDNA and DNases: New Biomarkers of Sepsis in Preterm Neonates—A Pilot Study

Cells ◽  
2022 ◽  
Vol 11 (2) ◽  
pp. 192
Author(s):  
Moritz Lenz ◽  
Thomas Maiberger ◽  
Lina Armbrust ◽  
Antonia Kiwit ◽  
Axel Von der Wense ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Dnase I ◽  
Sepsis Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Suspected Sepsis ◽  
Epidemiological Characteristics

Introduction: An early and accurate diagnosis of early onset neonatal sepsis (EONS) and late onset neonatal sepsis (LONS) is essential to improve the outcome of this devastating conditions. Especially, preterm infants are at risk. Reliable biomarkers are rare, clinical decision-making depends on clinical appearance and multiple laboratory findings. Markers of NET formation and NET turnover might improve diagnostic precision. Aim of this study was to evaluate the diagnostic value of NETs in sepsis diagnosis in neonatal preterm infants. Methods: Plasma samples of neonatal preterm infants with suspected sepsis were collected. Blood samples were assayed for markers of NET formation and NET turnover: cfDNA, DNase1, nucleosome, NE, and H3Cit. All clinical findings, values of laboratory markers, and epidemiological characteristics were collected retrospectively. Two subpopulations were created to divide EONS from LONS. EMA sepsis criteria for neonatal sepsis were used to generate a sepsis group (EMA positive) and a control group (EMA negative). Results: A total of 31 preterm neonates with suspected sepsis were included. Out of these, nine patients met the criteria for sepsis according to EMA. Regarding early onset neonatal sepsis (3 EONS vs. 10 controls), cfDNA, DNase I, nucleosome, and CRP were elevated significantly. H3Cit and NE did not show any significant elevations. In the late onset sepsis collective (6 LONS vs. 12 controls), cfDNA, DNase I, and CRP differed significantly compared to control group.

The Potential Value of Plasma Receptor Interacting Protein 3 for Neonatal Sepsis Diagnosis

2021 ◽  
Author(s):  
Chuchu Gao ◽  
Zongtai Feng ◽  
Lixia Wang ◽  
Xingxing Zhao ◽  
Kai Fu ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Diagnostic Value ◽  
Sepsis Group ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Interacting Protein ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Potential Value ◽  
Hs Crp

Abstract Background: Neonatal sepsis is a systemic inflammatory response syndrome in neonates. The molecular mechanism of neonatal sepsis remains incompletely clarified. The purpose of this study was to explore the potential value of receptor interacting protein 3 (RIP3) in neonatal sepsis.Methods: 93 neonates with sepsis and 93 neonates without infectious diseases were enrolled in this study from September 2019 to March 2021. Plasma RIP3 was detected by enzyme-linked immunosorbent assay (ELISA) and assessed along with whole blood hypersensitive C-reactive protein (hs-CRP) and platelet count (PLT). Differences of RIP3, hs-CRP and PLT between the two groups were compared. Changes of the three indicators in sepsis were also observed after treatment. The diagnostic value of indicators for neonatal sepsis was evaluated by receiver operating characteristic (ROC) curve.Results: In sepsis group, RIP3 and hs-CRP levels were significantly higher than those in control group (RIP3, p ＜ 0.0001; hs-CRP, p ＜ 0.0001), and PLT level was significantly lower than that in control group (p＜0.0001). After treatment, RIP3 and hs-CRP levels among septic survivors had a significant decrease (p＜0.0001) and PLT level had a significant improvement (p=0.0028). With RIP3＞15464.72 pg/mL, CRP>3.24 mg/L, PLT<205.00×109 /L as the positive criteria, the sensitivity of the three indicators in the diagnosis of neonatal sepsis was 68.8%, 64.5%, 59.1%, and the specificity was 91.4%, 82.8%, 79.6%, respectively. The combination of RIP3, CRP and PLT showed 76.3% sensitivity and 94.6% sensitivity.Conclusions: RIP3 may attribute to the early diagnosis and understanding therapeutic effect of neonatal sepsis. The combined detection of RIP3, CRP and PLT may be more effective than individual ones in the diagnosis of neonatal sepsis.

scholarly journals C-Reactive Protein Levels of Sepsis Patients: A Comparison of Three Immunoassay Methods

2019 ◽  
Vol 26 (1) ◽  
pp. 1
Author(s):  
Devi Rahmadhona ◽  
Aryati Aryati ◽  
Hardiono Hardiono
Keyword(s):  
Sepsis Group ◽  
C Reactive Protein ◽  
Sepsis Diagnosis ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Failure Assessment ◽  
Intensive Observation ◽  
Internal Medicine Wards ◽  
Selection Of

Quick Sequential Organ Failure Assessment (qSOFA) is a modification of the SOFA score that replaces the Systemic Inflammatory Response Syndrome (SIRS) criteria for sepsis diagnosis. C-reactive protein (CRP) is a marker to help diagnose sepsis. There are not many studies about comparison of CRP level with a variety of instruments and methods, currently. This study aimed to analyze differences in CRP results with particle enhanced turbidimetric immunoassay (PETIA), sandwich immunodetection and reflectometry-immunoassay patients. The study used samples of sepsis patients who were treated in emergency care unit, intensive observation rooms, Intensive Care Unit (ICU) and internal medicine wards of the Dr. Soetomo Hospital Surabaya in May-September 2018. A total of 65 sampels of sepsis patient fulfilled the qSOFA criteria. The CRP examination with the three methods were conducted on all study samples. There were significant differences in CRP levels in the sepsis group using the PETIA and Reflectometry immunoassay methods (p = 0.003), thus both of methods cannot be replace each other. There was no significant difference between CRP levels with PETIA and Sandwich Immunodetection (p=0.172) as well as Reflectometry immunoassay and Sandwich Immunodetection (p=0.251). The selection of instruments and methods for CRP examination is adjusted to laboratory needs and facilities.

scholarly journals Diagnostic value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for late-onset neonatal sepsis in infected preterm neonates

2018 ◽  
Vol 46 (4) ◽  
pp. 1606-1616 ◽  
Author(s):  
Senem Alkan Ozdemir ◽  
Esra Arun Ozer ◽  
Ozkan Ilhan ◽  
Sumer Sutcuoglu ◽  
Mansur Tatlı
Keyword(s):  
Preterm Infants ◽  
Predictive Value ◽  
Late Onset ◽  
Fatal Outcome ◽  
Myeloid Cells ◽  
Diagnostic Value ◽  
Sepsis Group ◽  
Preterm Neonates ◽  
Delivery Mode ◽  
Suspected Sepsis

Objective Sepsis is a complex clinical condition caused by a dysregulated immune response to an infection resulting in a fatal outcome. This study aimed to investigate the value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for diagnosing culture-proven sepsis in preterm infants. Methods Preterm neonates were evaluated for late-onset sepsis (LOS). Laboratory investigations were performed. Urine sTREM-1 samples and blood cultures were synchronously collected. Using blood culture results, preterm neonates were divided into the culture-proven group and suspected sepsis group. Results A total of preterm 62 infants were included in the study; 31 had culture-proven sepsis and 31 were suspected as having sepsis. There were no significant differences in gestational age, sex, birth weight, and delivery mode between the groups. Neonates in the culture-proven group had significantly higher urine sTREM-1 levels than did those in the suspected sepsis group. Using a cut-off point for a urine sTREM-1 level of 78.5 pg/mL, the sensitivity was 0.90, specificity was 0.78, positive predictive value was 0.68, and negative predictive value was 0.94. Conclusions The present study highlights the role of urine sTREM-1 levels in LOS. Urine sTREM-1 may be a reliable and sensitive marker in detecting sepsis in preterm infants.

scholarly journals Procalcitonin is a Prognosis Biomarker in Late Onset Neonatal Sepsis: A Pilot Study

2021 ◽  
Author(s):  
Valerie Ruetsch ◽  
Simon Barreault ◽  
Nolwenn Le Sache ◽  
Pierre Tissieres
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Area Under The Curve ◽  
Neonatal Morbidity ◽  
Good Prognosis ◽  
Operating Characteristics ◽  
Sepsis Diagnosis

Abstract Background. Neonatal sepsis contributes substantially to neonatal morbidity and mortality. Procalcitonin (PCT) is a recognized biomarker for the diagnosis of late-onset neonatal sepsis (LONS), however, little is known about the prognosis value of PCT in LONS. This study aims at assessing PCT value as a prognosis biomarker in preterm infants with LONS. Methods. Retrospective single center observational cohort. All premature infants (less than 32 weeks of gestational age) with LONS admitted in a tertiary neonatal intensive care unit.Discussion. Among the 59 preterm infants included in the analysis, 48 survived (81.4%, 48/59). Deceased patients had a significantly lower gestational age (p=0,025) and weight (p= 0,016) at the time of LONS diagnosis. Although PCT values were not different between both groups at the time of LONS diagnosis, it was more elevated during the first 24 hours in deceased patients (p=0,041). Accuracy of PCT for LONS prognosis ranged from 0.70 to 0.82 of area under the curve on reciever operating characteristics curves. Optimal PCT cut-off values at LONS diagnosis was 8,92 µg/L (Youden’s J index 0.53), 15.75 µg/L for PCT values during the first 24 hours (J index 0.56), and 6.74 µg/L between 24 and 48 hours after diagnosis (J index 0.54). The estimated survival probability at day 60 was above 95% for patient with a PCT value at sepsis diagnosis under 8,9 µg/L and less than 45% if higher (p<0.0001). Conclusion. A PCT value > 8.92 µg/L obtained at LONS diagnosis suspicion seems to be a good prognosis biomarker.

scholarly journals Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis

2021 ◽  
Vol 16 (03) ◽  
pp. 099-105
Author(s):  
Nuriye Asli Melekoglu ◽  
Seyma Yasar ◽  
Mehmet Keskin
Keyword(s):  
Neonatal Sepsis ◽  
Diagnostic Marker ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Suspected Sepsis ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Delta Neutrophil Index

Abstract Objective Sepsis diagnosis is challenging due to nonspecific symptomatology in newborns. Timely diagnosis is essential for reducing sepsis-related morbidity and mortality. This study was performed to determine the diagnostic value of the delta neutrophil index (DNI) for detection of neonatal sepsis and to compare its efficacy with other conventional markers. Methods This study was conducted at a tertiary hospital in newborns with confirmed sepsis (n = 59), suspected sepsis (n = 46), and in age- and weight-matched controls (n = 49). DNI, white blood cell count, C-reactive protein (CRP) level, and platelet measurements were determined, and blood cultures were performed at the onset of symptoms. Results The mean DNI was significantly higher in confirmed and clinical sepsis groups compared with the control group. (6.9 ± 9.3, 1.9 ± 2.1, and 0.4 ± 0.5, respectively, p < 0.001). ROC curve analysis also showed that the combination of DNI and CRP had the highest sensitivity (86%), specificity (100%), and positive predictive value (100%) for predicting neonatal sepsis. DNI values were significantly higher in nonsurvivors (p < 0.05). Conclusion DNI could be used as a reliable diagnostic marker for neonatal sepsis, and high DNI could predict sepsis development and unfavorable outcomes. The diagnostic capability of DNI may be increased by assessing CRP measurements simultaneously.

scholarly journals Association of inflammatory biomarkers with subsequent clinical course in suspected late onset sepsis in preterm neonates

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Şerife Kurul ◽  
Sinno H. P. Simons ◽  
Christian R. B. Ramakers ◽  
Yolanda B. De Rijke ◽  
René F. Kornelisse ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Medical Center ◽  
Inotropic Support ◽  
Inflammatory Biomarkers ◽  
Preterm Neonates ◽  
Sepsis Severity ◽  
Suspected Sepsis

Abstract Background Sepsis is a major health issue in preterm infants. Biomarkers are used to diagnose and monitor patients with sepsis, but C-reactive protein (CRP) is proven not predictive at onset of late onset neonatal sepsis (LONS) diagnosis. The aim of this study was to evaluate the association of interleukin-6(IL-6), procalcitonin (PCT) and CRP with subsequent sepsis severity and mortality in preterm infants suspected of late onset neonatal sepsis. Methods The study was conducted at the Erasmus University Medical Center–Sophia Children’s Hospital Rotterdam. Patient data from January 2018 until October 2019 were reviewed for all preterm neonates born with a gestational age below 32 weeks with signs and symptoms suggestive of systemic infection, in whom blood was taken for blood culture and for inflammatory biomarkers determinations. Plasma IL-6 and PCT were assessed next to CRP at the moment of suspicion. We assessed the association with 7-day mortality and sepsis severity (neonatal sequential organ failure assessment (nSOFA) score, need for inotropic support, invasive ventilation and thrombocytopenia). Results A total of 480 suspected late onset neonatal sepsis episodes in 208 preterm neonates (gestational age < 32 weeks) were retrospectively analyzed, of which 143 episodes were classified as sepsis (29.8%), with 56 (11.7%) cases of culture negative, 63 (13.1%) cases of gram-positive and 24(5.0%) cases of gram-negative sepsis. A total of 24 (5.0%) sepsis episodes resulted in death within 7 days after suspicion of LONS. Both IL-6 (adjusted hazard ratio (aHR): 2.28; 95% CI 1.64–3.16; p < 0.001) and PCT (aHR: 2.91; 95% CI 1.70–5.00; p < 0.001) levels were associated with 7-day mortality; however, CRP levels were not significantly correlated with 7-day mortality (aHR: 1.16; 95% CI (0.68–2.00; p = 0.56). Log IL-6, log PCT and log CRP levels were all significantly correlated with the need for inotropic support. Conclusions Our findings show that serum IL-6 and PCT levels at moment of suspected late onset neonatal sepsis offer valuable information about sepsis severity and mortality risk in infants born below 32 weeks of gestation. The discriminative value was superior to that of CRP. Determining these biomarkers in suspected sepsis may help identify patients with imminent severe sepsis, who may require more intensive monitoring and therapy.

scholarly journals VALIDITY OF C- REACTIVE PROTEIN IN DIAGNOSIS OF NEONATAL SEPSIS.

2020 ◽  
pp. 1-4
Author(s):  
Ghongade P. G. ◽  
Khaire P. B.
Keyword(s):  
Birth Weight ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Screening Test ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Suspected Sepsis ◽  
Adequate Treatment ◽  
Reactive Protein

Background: Neonatal sepsis with its high incidence &grave prognosis, in spite of adequate treatment with modern antibiotics, has been a challenge for all times. Optimal diagnosis and treatment strategies are difficult to define. It is essential to diagnose early with laboratory investigation like serial CRP; so that a feasible, rapid and a relatively economic method to diagnose neonatal sepsis at earliest can be instituted even at basic health care level. hence a study was planned to find out the role of CRP against blood culture in early detection of neonatal sepsis. Aim & Objective: To evaluate Validity of C-Reactive Protein as a screening test in neonatal sepsis. Material and Method: This prospective study was carried out inpaediatric dept of medical college. 100 neonates (≤ 28 days) with suspected neonatal sepsis having a birth weight of ≥ 1000 grams admitted during a period from January 2020 to March 2020 were screened primarily with C-Reactive Protein. Serial level of CRPon the day of admission,2nd ,4th ,6th ,8th& 10th day was compared with the serial blood cultureon the day of admission,8th,15th& 21st day to establish the validity of CRP as a screening test.Data analysis carried out by Percentages, Chi Square test, Sensitivity, Specificity, Positive predictive value, Negative predictive value. Results: Amongst 100neonate 76% were early neonates,65% were low birth weight,CRP was having high sensitivity & specificity(78.57%,76.74% respectively). ROC analysis showed AUC 0.8 with p<0.001.Conclusion: CRP is a good screening test & establishes its validity in diagnosing suspected sepsis.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

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