Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (06): 643 -649. doi: 10.3877/cma.j.issn.1673-5250.2021.06.004

Forum

Advance of potential biomarkers in neonatal sepsis

Yang Cao, Hanmin Liu()   

  • Received:2021-07-29 Revised:2021-11-07 Published:2021-12-01
  • Corresponding author: Hanmin Liu
  • Supported by:
    Key R&D Project of Sichuan Provincial Department of Science and Technology(2019YFS0037)

Neonatal sepsis (NS), remains a major cause of mortality among neonates worldwide, accounting for approximately 16% neonatal mortality. NS is divided into early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS). Nevertheless, the clinical therapy of NS is usually delayed due to lack of biomarkers with high specificity. Thus, it is crucial to investigate ideal biomarkers for earlier diagnosis and treatment of NS, and avoiding complications of neonates. Biomarkers have been widely used including C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA). We are aiming to summarize classifications and clinical characteristics, diagnosis and therapy, and advances of potential biomarkers in NS.

[1]
Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis[J]. Lancet2017390(10104):1770-1780. DOI:10.1016/S0140-6736(17)31002-4.
[2]
Kim F, Polin RA, Hooven TA. Neonatal sepsis[J]. BMJ2020371:m3672. DOI:10.1136/bmj.m3672.
[3]
Fleischmann-Struzek C, Goldfarb DM, Schlattmann P,et al. The global burden of paediatric and neonatal sepsis: a systematic review[J]. Lancet Respir Med20186(3):223-230. DOI:10.1016/S2213-2600(18)30063-8.
[4]
Workneh Bitew Z, Worku T, Alemu A. Effects of vitamin D on neonatal sepsis: a systematic review and Meta-analysis[J]. Food Sci Nutr20219(1):375-388. DOI:10.1002/fsn3.2003.
[5]
Berlak N, Shany E, Ben-Shimol S,et al. Late onset sepsis: comparison between coagulase-negative staphylococci and other bacteria in the neonatal intensive care unit [J]. Infect Dis (Lond)201850(10):764-770. DOI:10.1080/23744235.2018.1487075.
[6]
Bourika V, Hantzi E, Michos A,et al. Clinical value of serum amyloid-A protein, high-density lipoprotein cholesterol and apolipoprotein-A1 in the diagnosis and follow-up of neonatal sepsis[J]. Pediatr Infect Dis J202039(8):749-755. DOI:10.1097/INF.0000000000002682.
[7]
Hashem HE, El Masry SA, Mokhtar AM,et al. Valuable role of neutrophil CD64 and highly sensitive CRP biomarkers for diagnostic, monitoring, and prognostic evaluations of sepsis patients in neonatal ICUs[J]. Biomed Res Int20202020:6214363. DOI:10.1155/2020/6214363.
[8]
Chauhan N, Tiwari S, Jain U. Potential biomarkers for effective screening of neonatal sepsis infections: an overview[J]. Microb Pathog2017107:234-242. DOI:10.1016/j.micpath.2017.03.042.
[9]
Malcolmson C, Ng K, Hughes S,et al. Impact of matrix-assisted laser desorption and ionization time-of-flight and antimicrobial stewardship intervention on treatment of bloodstream infections in hospitalized children[J]. J Pediatr Infect Dis Soc20176(2):178-186. DOI:10.1093/jpids/piw033.
[10]
Celik IH, Hanna M, Canpolat FE, et al. Diagnosis of neonatal sepsis: the past, present and future [J]. Pediatr Res, 2022, 91(2): 337-350. DOI: 10.1038/s41390-021-01696-z.
[11]
Stoll BJ, Puopolo KM, Hansen NI,et al. Early-onset neonatal sepsis 2015 to 2017, the rise of Escherichia coli, and the need for novel prevention strategies[J]. JAMA Pediatr2020174(7):e200593. DOI:10.1001/jamapediatrics.2020.0593.
[12]
Esposito S, Principi N. Adjunctive therapy to treat neonatal sepsis[J]. Expert Rev Clin Pharmacol202013(1):65-73. DOI:10.1080/17512433.2020.1699790.
[13]
Leal YA, Álvarez-Nemegyei J, Lavadores-May AI,et al. Cytokine profile as diagnostic and prognostic factor in neonatal sepsis[J]. J Matern Fetal Neonatal Med201932(17):2830-2836. DOI:10.1080/14767058.2018.1449828.
[14]
Raveendran AV, Kumar A, Gangadharan S. Biomarkers and newer laboratory investigations in the diagnosis of sepsis[J]. J R Coll Physicians Edinb201949(3):207-216. DOI:10.4997/JRCPE.2019.308.
[15]
Memar MY, Alizadeh N, Varshochi M,et al. Immunologic biomarkers for diagnostic of early-onset neonatal sepsis[J]. J Matern Fetal Neonatal Med201932(1):143-153. DOI:10.1080/14767058.2017.1366984.
[16]
Balayan S, Chauhan N, Chandra R,et al. Recent advances in developing biosensing based platforms for neonatal sepsis[J]. Biosens Bioelectron2020169:112552. DOI:10.1016/j.bios.2020.112552.
[17]
Pierrakos C, Velissaris D, Bisdorff M,et al. Biomarkers of sepsis: time for a reappraisal[J]. Crit Care202024(1):287. DOI:10.1186/s13054-020-02993-5.
[18]
Brown J, Meader N, Wright K,et al. Assessment of C-reactive protein diagnostic test accuracy for late-onset infection in newborn infants: a systematic review and Meta-analysis[J]. JAMA Pediatr2020174(3):260-268. DOI:10.1001/jamapediatrics.2019.5669.
[19]
Tessema B, Lippmann N, Willenberg A, et al. The diagnostic performance of interleukin-6 and C-reactive protein for early identification of neonatal sepsis [J]. Diagnostics (Basel), 2020, 10(11): 978. DOI: 10.3390/diagnostics10110978.
[20]
Velissaris D, Zareifopoulos N, Lagadinou M,et al. Procalcitonin and sepsis in the Emergency Department: an update[J]. Eur Rev Med Pharmacol Sci202125(1):466-479. DOI:10.26355/eurrev_202101_24416.
[21]
Stocker M, van Herk W, El Helou S,et al. C-reactive protein, procalcitonin, and white blood count to rule out neonatal early-onset sepsis within 36 hours: a secondary analysis of the Neonatal Procalcitonin Intervention Study[J]. Clin Infect Dis202173(2):e383-383e390. DOI:10.1093/cid/ciaa876.
[22]
Yang KD, He Y, Xiao S,et al. Identification of progranulin as a novel diagnostic biomarker for early-onset sepsis in neonates[J]. Eur J Clin Microbiol Infect Dis202039(12):2405-2414. DOI:10.1007/s10096-020-03981-x.
[23]
Bang YJ, Hu Z, Li Y,et al. Serum amyloid A delivers retinol to intestinal myeloid cells to promote adaptive immunity[J]. Science2021373(6561):eabf9232. DOI:10.1126/science.abf9232.
[24]
Bengnér J, Quttineh M, Gäddlin PO,et al. Serum amyloid A - A prime candidate for identification of neonatal sepsis[J]. Clin Immunol2021229:108787. DOI:10.1016/j.clim.2021.108787.
[25]
Meng L, Song Z, Liu A,et al. Effects of lipopolysaccharide-binding protein (LBP) single nucleotide polymorphism (SNP) in infections, inflammatory diseases, metabolic disorders and cancers[J]. Front Immunol202112:681810. DOI:10.3389/fimmu.2021.681810.
[26]
Gradek-Kwinta E, Czyzycki M, Lopatkiewicz AM,et al. Lipopolysaccharide binding protein and sCD14 as risk markers of stroke-associated pneumonia[J]. J Neuroimmunol2021354:577532. DOI:10.1016/j.jneuroim.2021.577532.
[27]
García de Guadiana Romualdo L, Albaladejo Otón MD, Rebollo Acebes S,et al. Diagnostic accuracy of lipopolysaccharide-binding protein for sepsis in patients with suspected infection in the emergency department[J]. Ann Clin Biochem201855(1):143-148. DOI:10.1177/0004563217694378.
[28]
Venet F, Monneret G. Advances in the understanding and treatment of sepsis-induced immunosuppression[J]. Nat Rev Nephrol201814(2):121-137. DOI:10.1038/nrneph.2017.165.
[29]
Grondman I, Pirvu A, Riza A,et al. Biomarkers of inflammation and the etiology of sepsis[J]. Biochem Soc Trans202048(1):1-14. DOI:10.1042/BST20190029.
[30]
Cortés JS, Losada PX, Fernández LX, et al. Interleukin-6 as a biomarker of early-onset neonatal sepsis [J]. Am J Perinatol, 2021, 38(S 01): e338-e346. DOI: 10.1055/s-0040-1710010.
[31]
Berka I, Korček P, Straňák Z. C-reactive protein, interleukin-6, and procalcitonin in diagnosis of late-onset bloodstream infection in very preterm infants [J]. J Pediatric Infect Dis Soc, 2021, piab071. DOI: 10.1093/jpids/piab071.
[32]
AbdAllah NB, Toraih EA, Al Ageeli E,et al. MYD88, NFKB1, and IL6 transcripts overexpression are associated with poor outcomes and short survival in neonatal sepsis[J]. Sci Rep202111(1):13374. DOI:10.1038/s41598-021-92912-7.
[33]
Ebenebe CU, Hesse F, Blohm ME,et al. Diagnostic accuracy of interleukin-6 for early-onset sepsis in preterm neonates[J]. J Matern Fetal Neonatal Med202134(2):253-258. DOI:10.1080/14767058.2019.1606194.
[34]
Nakstad B. The diagnostic utility of procalcitonin, interleukin-6 and interleukin-8, and hyaluronic acid in the Norwegian consensus definition for early-onset neonatal sepsis (EONS)[J]. Infect Drug Resist201811:359-368. DOI:10.2147/IDR.S155965.
[35]
Kalayci AG, Adam B, Yilmazer F, et al. The value of immunoglobulin and complement levels in the early diagnosis of neonatal sepsis[J].Acta Paediatr, 1997, 86(9): 999-1002. DOI: 10.1111/j.1651-2227.1997.tb15187.x.
[36]
Omran A, Sobh H, Abdalla MO,et al. Salivary and serum interleukin-10, C-reactive protein, mean platelet volume, and CRP/MPV ratio in the diagnosis of late-onset neonatal sepsis in full-term neonates[J]. J Immunol Res20212021:4884537. DOI:10.1155/2021/4884537.
[37]
Froeschle GM, Bedke T, Boettcher M, et al. T cell cytokines in the diagnostic of early-onset sepsis[J]. Pediatr Res202190(1):191-196. DOI:10.1038/s41390-020-01248-x.
[38]
Chen W, Lai D, Li Y,et al. Neuronal-activated ILC2s promote IL-17A production in lung γδ T cells during sepsis[J]. Front Immunol202112:670676. DOI:10.3389/fimmu.2021.670676.
[39]
Pietrasanta C, Ronchi A, Vener C, et al. Presepsin (Soluble CD14 Subtype) as an early marker of neonatal sepsis and septic shock: a prospective diagnostic trial [J]. Antibiotics (Basel), 2021, 10(5): 580. DOI: 10.3390/antibiotics10050580.
[40]
van Maldeghem I, Nusman CM, Visser DH. Soluble CD14 subtype (sCD14-ST) as biomarker in neonatal early-onset sepsis and late-onset sepsis: a systematic review and Meta-analysis[J]. BMC Immunol201920(1):17. DOI:10.1186/s12865-019-0298-8.
[41]
Hung SK, Lan HM, Han ST, et al. Current evidence and limitation of biomarkers for detecting sepsis and systemic infection [J]. Biomedicines, 2020, 8(11): 494. DOI: 10.3390/biomedicines8110494.
[42]
Kalia N, Singh J, Kaur M. The ambiguous role of mannose-binding lectin (MBL) in human immunity[J]. Open Med (Wars)202116(1):299-310. DOI:10.1515/med-2021-0239.
[43]
Lemańska-Perek A, Adamik B. Fibronectin and its soluble EDA-FN isoform as biomarkers for inflammation and sepsis[J]. Adv Clin Exp Med201928(11):1561-1567. DOI:10.17219/acem/104531.
[44]
Doni A, Mantovani A, Bottazzi B, et al. PTX3 regulation of inflammation, hemostatic response, tissue repair, and resolution of fibrosis favors a role in limiting idiopathic pulmonary fibrosis [J]. Front Immunol, 2021, 12: 676702. DOI: 10.3389/fimmu.2021.676702.
[45]
Lee YT, Gong M, Chau A, et al. Pentraxin-3 as a marker of sepsis severity and predictor of mortality outcomes: a systematic review and Meta-analysis [J]. J Infect, 2018, 76(1): 1-10. DOI: 10.1016/j.jinf.2017.10.016.
[46]
Bourika V, Bartzeliotou A, Spiliopoulou C,et al. Paraoxonase (PON)-1 activity in septic neonates: One more arrow in the quiver of biomarkers of neonatal sepsis?[J]. Clin Biochem202193:119-121. DOI:10.1016/j.clinbiochem.2021.03.019.
[1] Shuihua Yang, Guidan He, Guican Qin, Mengfeng Liang, Yanhe Luo, Xueqin Li, Juansong Tang. Echocardioimagedata characteristics of fetal isolated total anomalous pulmonary venous connection and application of high definition flow imaging and spatio-temporal image correlation[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1061-1067.
[2] Heng Lyu, Licong Dong, Haiqin Xie, Zhuofei Zhao, Li Liu, Desheng Sun. CT-ultrasound comparison for evaluating missed diagnosis of focal liver lesions by ultrasound: a single-center cross-sectional quality control survey[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 712-716.
[3] Kang Ying, Canying Yang, Fengzhen Liu, Lili Chen, Yanna Liu. Prognostic value of left ventricular myocardial strain in asymptomatic patients with severe aortic stenosis[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(06): 581-587.
[4] Xu Peng, Yongfu Shao, Duo Li, Rui Zhou, Zhenming Xing. Diagnosis and surgical treatment of hepatocolon flexure[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 108-110.
[5] Qian Yang, Cuifang Li, Wanqiu Zhang. Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 33-36.
[6] Yansong Li, Huimin Feng, Mingchao Liu, Zepeng Liu, Qiuxia Jiang. Expression and clinical significance of STIP1 in triple negative breast cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 52-56.
[7] Bing Pan, Shaocheng Lyu, Xin Zhao, Lixin Li, Ren Lang, Qiang He. Effect of number of dissected lymph nodes on efficacy of pancreaticoduodenectomy for distal cholangiocarcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 608-612.
[8] Qikun Zhang, Fuchao Shang, Qi Li, Guangming Li, Menglong Wang. Survival benefit of combined splenectomy in patients with liver cancer complicated with portal hypertension after radical resection[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 613-618.
[9] Ruiqi Gu, Hongsheng Fang, Guoxiang Cai. Application and progress of circulating tumor DNA detection technology in the diagnosis and treatment of colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 453-459.
[10] Yanjun Lu, Jian Ma, Pengyu Bai, Linghong Guo, Haiyi Liu, Bo Jiang, Wenqi Bai, Yixun Zhang. Clinical effect of Nano-carbon on 253 groups of lymph node dissection in laparoscopic radical resection of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 473-477.
[11] Lili Zhao, Kuixiang Wang, Xiaochong Zhang, Zhiyuan Li. Diagnostic value of ESR to C-Reactive protein ratio in diagnosis of periprosthetic joint Infection[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(06): 351-355.
[12] Yongsheng Li, Jiahe Sun, Shuwei Guo, Yikang Lu, Hongzhou Liu. Short-term postoperative complications and their influencing factors in elderly patients with colorectal cancer[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 962-967.
[13] Jun Wang, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Libin Suo, Jun Chen, chengli Miao, Chenghua Luo. Retrospective analysis of anesthesia management of massive transfusion patients undergoing retroperitoneal tumor resection[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 844-849.
[14] Tian Li, Hong Xu, Heliang Liu. Progress in research of pneumoconiosis[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 900-905.
[15] Libin Suo, Kunpeng Liu, Lan Yao, Hua Zhang, Yue Wei, Jun Wang, Jun Chen, Chengli Miao, Chenghua Luo. Key points of anesthesia management and prognostic factors in patients undergoing primary retroperitoneal paraganglioma resection[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(07): 771-776.
Viewed
Full text


Abstract