Biomarkers in Diagnosing Late-onset Neonatal Sepsis

Adem POLAT1, Turan TUNÇ1, Buket KILIÇASLAN2 , Hacer ERGİN3, Dilek DİLLİ4, Ramazan ÖZDEMİR5, Emrah CAN6, Sinan USLU7 Turkish Neonatal Sepsis Study Group: Emel OKULU8, Özge AYDEMİR9, Bahri ERMİŞ10, Sara EROL11, Nazlı GÜLTEKİN12, Merih ÇETÌNKAYA13, Nilüfer GÜZOĞLU14, Deniz HANTA15, Beyza ÖZCAN16, Fatma NARTER17, H. Tolga ÇELİK18 Article History: Received: March 11, 2021; Accepted: March 22, 2021; Published: March 31, 2021. Research Article ISSN 2572-4355 Citation Adem POLAT et al. (2021), Biomarkers in Diagnosing Late-onset Neonatal Sepsis. Int J Ped & Neo Heal. 5:3, 23-32 Background 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. Methods 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. Results 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. Conclusion Serum PTX-3, Pro-ADM and sTREM-1 levels did not indicate LOS diagnosis. Regarding previous studies Volume 5 Issue 3, March 2021 Published by Biocore Group | www.biocoreopen. org/ijpn/archive.php 23 1Gülhane Military Medical Academy, School of Medicine, Department of Pediatrics, Division of Neonatology, Turkey 2Special Adana Metro Hospital, Division of Neonatology, Turkey 3Pamukkale University School of Medicine, Department of Pediatrics, Division of Neonatology, Turkey 4Dr Sami Ulus Children’s Hospital, Turkey 5Inonu University School of Medicine, Department of Pediatrics, Division of Neonatology, Turkey 6Bagcılar Training and Research Hospital, Division of Neonatology, Turkey 7Sisli Hamidiye Etfal Educational and Research Hospital, Division of Neonatology, Turkey 8Ankara University School of Medicine Department of Pediatrics Division of Neonatology, Turkey 9Osman Gazi University School of Medicine, Department of Pediatrics Division of Neonatology, Turkey 10SakaryaUniversity School of Medicine, Department of Pediatrics Division of Neonatology, Turkey 11Etlik Zubeyde Hanim Maternity and Research Hospital Division of Neonatology, Turkey 12Meram School of Medicine, Department of Pediatrics Division of Neonatology, Turkey 13Kanuni Educational and Research Hospital Division of Neonatology, Turkey 14Kırıkkale School of Medicine, Department of Pediatrics Division of Neonatology, Turkey 15 Adana Maternity and Children’s Hospital, Turkey 16Konya Training and Research Hospital, Turkey 17Dr Lutfi Kırdar Kartal Education and Research Hospital, Turkey 18Hacettepe University Faculty of Medicine Department of Pediatrics Division of Neonatology, Turkey