Biomarkers for neonatal sepsis: recent developments

Abstract

As a leading cause of neonatal morbidity and mortality, neonatal sepsis remains a significant global health challenge. Despite recent advances in the management of neonatal sepsis, including use of more potent antibiotics, timely identification continues to be a frequent and challenging problem in the management of the newborn or high-risk neonate in the neonatal intensive care unit. Lack of specific early objective diagnostic evaluations or specific signs and symptoms, especially in the preterm infant, impedes early identification. However, emerging technologies linked with enhanced understanding of the immature and developing neonatal immune system responses to early infection provide an opportunity to develop critically needed biomarkers to improve early identification in this high-risk population. This review will focus on the field of neonatal sepsis biomarker development, identifying current promising biomarkers that have been investigated and widely utilized, as well as provide insight into recent advances and the rapidly evolving technologies that are being exploited in biomarker development to improve diagnosis, treatment, and prognosis in neonatal sepsis.

The Diagnostic Performance of Interleukin-6 and C-Reactive Protein for Early Identification of Neonatal Sepsis

“…Risk factors associated to high prevalence of neonatal sepsis include the need for invasive procedures combined with immunological immaturity [ 5 ]. Early diagnosis of neonatal sepsis is still a challenge because of its non-specific clinical presentation and difficulty in differentiating from non-infectious conditions like respiratory distress syndrome or maladaptation [ 1 , 6 ].…”

Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis

“…This is in agreement with previous reviews. [7][8][9]35 Interpretation of national-based data from our survey alone is not possible because of the low number of participants in each country. Nevertheless, the data reflect the trends of the recommendations of the national guidelines.…”

“…Nevertheless, diagnosis is difficult because of the often subtle, nonspecific clinical presentation and low predictive values of any biomarkers. 3,[7][8][9] Uncertainty about the presence of infection may result in unnecessary and prolonged empiric antibiotic treatment. 10 Guidelines play a crucial role in supporting decision-making for this vulnerable group of patients.…”

Biochemical and immunological markers for the early diagnosis of neonatal septicaemia

“…Neonatal sepsis (NS) is a major cause of mortality and morbidity in newborn, and it is recognized as a global public health challenge. 1,2 World Health Organization (WHO) estimates that 1 million deaths per year occur due to neonatal sepsis, and 42% of these deaths occur in the first week of life. 3,4 Incidence of NS in south Asia is 4-10 times higher than that of developed countries.…”