Assessment of novel biomarkers: sTREM-1, pentraxin-3 and pro-adrenomedullin in the early diagnosis of neonatal early onset sepsis

Article type: Research Article

Authors: Tunç, T.^{a; *} | Polat, A.^a | Özdemir, R.^b | Kiliçaslan, B.^c | Can, E.^d | Çelik, H.T.^e | Arsan, S.^f | Kader, Ş^g | Erol, S.^h | Uslu, S.ⁱ | Özdemir, Ö.M.A.^j | Turkish Neonatal Sepsis Group | Özcan, B.^k | Hanta, D.^l | Dilli, D.^m | Narter, F.ⁿ | Gültekin, N.^o | Güzoğlu, N.^p | Aydemir, Ö.^q

Affiliations: [a] Department of Pediatrics, Division of Neonatology, Gülhane Military Medical Academy, School of Medicine, Turkey | [b] Department of Pediatrics, Division of Neonatology, Inonu University School of Medicine, Turkey | [c] Division of Neonatology, Special Adana Metro Hospital, Turkey | [d] Division of Neonatology, Bagcılar Training and Research Hospital, Turkey | [e] Department of Pediatrics, Division of Neonatology, Hacettepe University Faculty of Medicine, Turkey | [f] Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Turkey | [g] Department of Pediatrics, Division of Neonatology, Karadeniz Technical University School of Medicine, Turkey | [h] Etlik Zubeyde Hanim Maternity and Research Hospital Division of Neonatology | [i] Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Turkey | [j] Department of Pediatrics, Division of Neonatology, Pamukkale University School of Medicine, Turkey | [k] Konya Training and Research Hospital, Turkey | [l] Adana Maternity and Children’s Hospital, Turkey | [m] Dr Sami Ulus Children’s Hospital, Turkey | [n] Dr Lutfi Kırdar Kartal Education and Research Hospital, Turkey | [o] Department of Pediatrics, Division of Neonatology, Meram School of Medicine, Turkey | [p] Department of Pediatrics, Division of Neonatology, Kırıkkale School of Medicine, Turkey | [q] Department of Pediatrics, Division of Neonatology, Osman Gazi University School of Medicine, Turkey

Correspondence: [*] Address for correspondence: Turan Tunc, MD, Associate Professor of Pediatrics, Department of Pediatrics, Division of Neonatology, Gulhane Military Medical Academy, Ankara, Turkey. Tel.: +90 312 3044388; E-mail: drturantunc@gmail.com.

Abstract: BACKGROUND:Early onset bacterial sepsis in neonates (EOS) is recognized as an important health condition. Early diagnosis is crucial. However, blood culture results are released in 48–72 hours. Many biomarkers have been investigated but none have been accepted as the gold standard. This study aimed to investigate the diagnostic value of the molecules: soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1), pentraxin-3 (PTX-3) and pro adrenomedullin (pro-ADM) in EOS and compare with currently used biomarkers. METHODS:In this multicenter prospective study, patients were enrolled from different NICUs around the Turkey. Patient data were collected via web-based registry system from attending centers. Neonates, hospitalized with a suspicion of EOS were enrolled. Blood culture and routine blood tests were collected and a serum sample was obtained and kept in – 80°C for studying the molecules. According to laboratory results, patients were divided into three groups as; proven sepsis, clinical sepsis and control group. Groups were compared in terms of demographic, clinical and laboratory findings. The primary outcome of the study was to assess any difference between groups in terms of the diagnostic value of the markers aforementioned. RESULTS:A total of 130 patients were enrolled; proven sepsis (n = 36), clinical sepsis (n = 53) and control (n = 41) groups. Groups were similar in terms of demographic findings; mean WBC (P = 0.445), procalcitonin (PCT) (P = 0.083) and IL-6 (P = 0.814) levels. Mean C-reactive protein (CRP) level was significantly higher in clinical sepsis and proven sepsis groups compared to control group (P < 0.001). Mean PTX-3 (P = 0.547), pro-ADM (P = 0.766) and sTREM-1 (P = 0.838) levels were similar between groups. CONCLUSION:These promising molecules failed to help in early diagnosis of EOS. Their relation to correlation with disease progression may make more sense as they seem to be expressed in higher amounts with the progression of the disease in previous studies. CRP was the most frequently used biomarker for detecting the sepsis in our study population.

Keywords: Key words: Biomarker, neonatal early onset sepsis, pentraxin-3, pro-ADM, sTREM-1

DOI: 10.3233/NPM-180131

Journal: Journal of Neonatal-Perinatal Medicine, vol. 13, no. 1, pp. 47-54, 2020