Differential approach to the diagnosis of early-onset neonatal sepsis in preterm infants
Background. Early-onset neonatal sepsis remains the leading cause of morbidity and mortality in premature babies. The problem of timely diagnosis necessitates the introduction of new effective biomarkers for monitoring sepsis in newborns. Objective: improving the diagnosis of early-onset neonatal sepsis in premature babies by determining the diagnostic significance of the serum level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), developing a comprehensive algorithm and evaluating the effectiveness of the approach. Materials and methods. An analysis of clinical and laboratory observations of 70 premature infants with early neonatal sepsis (n = 22) and intrauterine pneumonia (n = 48) was carried out with determination of serum sTREM-1 content. Results. In infants with early-onset neonatal sepsis, a significant decrease in sTREM-1 level was revealed compared to infants with intrauterine pneumonia (97.1 ± 4.5 pg/ml versus 134.00 ± 7.73 pg/ml). Using the heterogeneous sequential Wald-Genkin procedure, the established rank structures of diagnostic indicators were established and an effective multimarker diagnostic model was developed. Conclusions. It was found that the content of sTREM-1 in the blood serum of children at risk of intrauterine infection < 148 pg/ml on the first day of life was significantly associated with neonatal sepsis. Using the developed multimarker algorithm helps improve the diagnosis of early-onset neonatal sepsis.
Full Text:PDF (Українська)
Puopolo KM, Benitz WE, Zaoutis TE; Committee on Fetus and Newborn; Committee on Infectious Diseases. Management of Neonates Born at </=34 6/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. 2018 Dec;142(6). pii: e20182896. doi: 10.1542/peds.2018-2896.
World Health Organization (WHO). Sepsis. Available from: https://www.who.int/news-room/fact-sheets/detail/sepsis. Accessed: April 19, 2018.
Center for Medical Statistics of the Ministry of Health of Ukraine. Statistics. Available from: http://medstat.gov.ua/ukr/statdan.html.
Memar MY, Alizadeh N, Varshochi M, Kafil HS. Immunologic biomarkers for diagnostic of early-onset neonatal sepsis. J Matern Fetal Neonatal Med. 2019 Jan;32(1):143-153. doi: 10.1080/14767058.2017.1366984.
Bellos I, Fitrou G, Daskalakis G, Thomakos N, Papantoniou N, Pergialiotis V. Soluble TREM-1 as a predictive factor of neonatal sepsis: a meta-analysis. Inflamm Res. 2018 Jul;67(7):571-578. doi: 10.1007/s00011-018-1149-4.
Tammaro A, Derive M, Gibot S, Leemans JC, Florquin S, Dessing MC. TREM-1 and its potential ligands in non-infectious diseases: from biology to clinical perspectives. Pharmacol Ther. 2017 Sep;177:81-95. doi: 10.1016/j.pharmthera.2017.02.043.
Arts RJ, Joosten LA, van der Meer JW, Netea MG. TREM-1: intracellular signaling pathways and interaction with pattern recognition receptors. J Leukoc Biol. 2013 Feb;93(2):209-15. doi: 10.1189/jlb.0312145.
Cao C, Gu J, Zhang J. Soluble triggering receptor expressed on myeloid cell-1 (sTREM-1): a potential biomarker for the diagnosis of infectious diseases. Front Med. 2017 Jun;11(2):169-177. doi: 10.1007/s11684-017-0505-z.
Arizaga-Ballesteros V, Alcorta-Garcia MR, Lazaro-Martinez LC, al. Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study. Int J Infect Dis. 2015 Jan;30:27-32. doi: 10.1016/j.ijid.2014.10.013.
Saldir M, Tunc T, Cekmez F, et al. Endocan and Soluble Triggering Receptor Expressed on Myeloid Cells-1 as Novel Markers for Neonatal Sepsis. Pediatr Neonatol. 2015 Dec;56(6):415-21. doi: 10.1016/j.pedneo.2015.03.006.
Patoulias D, Kalogirou MS, Patoulias I. Triggering Receptor Expressed on Myeloid Cells-1 (TREM-1) and its soluble in the plasma form (sTREM-1) as a diagnostic biomarker in neonatal sepsis. Folia Med Cracov. 2018;58(2):15-19. doi: 10.24425/fmc.2018.124655.
Gubler EV. Vychislitel'nye metody analiza i raspoznavaniia patologicheskikh protsessov [Computational methods for the analysis and recognition of pathological processes]. SPb: Meditsina; 1978. 296 p. (in Russian).
Shi X, Zhang Y, Wang H, Zeng S. Effect of Triggering Receptor Expressed on Myeloid Cells 1 (TREM-1) Blockade in Rats with Cecal Ligation and Puncture (CLP)-Induced Sepsis. Med Sci Monit. 2017 Oct 23;23:5049-5055. doi: 10.12659/msm.904386.
Copyright (c) 2020 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020