Differential approach to the diagnosis of early-onset neonatal sepsis in preterm infants

Authors

  • T.M. Klymenko MD, PhD, Professor, Head of the department of neonatology, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
  • K.O. Kosenko PhD student, Department of neonatology, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine http://orcid.org/0000-0002-8919-0917

DOI:

https://doi.org/10.22141/2224-0551.14.7.2019.184621

Keywords:

early-onset neonatal sepsis, TREM-1, preterm infants

Abstract

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.

Downloads

Download data is not yet available.

References

Kostiyk О, Shynko Y, Krasnova Y. Earle neonatal sepsis. Main direction of diagnostics and treatment. Neonatology, surgery and perinatal medicine. 2014;4(13):105-110. (in Ukrainian).

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.

Dobryansky DO. Modern approaches to diagnosis and treatment of neonatal sepsis. Neonatology, surgery and perinatal medicine. 2013;3(10):106-117. (in Ukrainian).

Hibbert JE, Currie A, Strunk T. Sepsis-Induced Immunosuppression in Neonates. Front Pediatr. 2018 Nov 29;6:357. doi: 10.3389/fped.2018.00357.

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.

Wynn JL. Defining neonatal sepsis. Curr Opin Pediatr. 2016 Apr;28(2):135-40. doi: 10.1097/MOP.0000000000000315.

Iroh Tam PY, Bendel CM. Diagnostics for neonatal sepsis: current approaches and future directions. Pediatr Res. 2017 Oct;82(4):574-583. doi: 10.1038/pr.2017.134.

Chauhan N, Tiwari S, Jain U. Potential biomarkers for effective screening of neonatal sepsis infections: An overview. Microb Pathog. 2017 Jun;107:234-242. doi: 10.1016/j.micpath.2017.03.042.

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.

Tzialla C, Manzoni P, Achille C, Bollani L, Stronati M, Borghesi A. New Diagnostic Possibilities for Neonatal Sepsis. Am J Perinatol. 2018 May;35(6):575-577. doi: 10.1055/s-0038-1639361.

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).

Weber B, Schuster S, Zysset D, et al. TREM-1 deficiency can attenuate disease severity without affecting pathogen clearance. PLoS Pathog. 2014 Jan;10(1):e1003900. doi: 10.1371/journal.ppat.1003900.

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.

Published

2021-09-10

How to Cite

Klymenko, T., & Kosenko, K. (2021). Differential approach to the diagnosis of early-onset neonatal sepsis in preterm infants. CHILD`S HEALTH, 14(7), 415–419. https://doi.org/10.22141/2224-0551.14.7.2019.184621

Issue

Section

Neonatology