Reducing the hazards of the early-onset neonatal sepsis (EONS) is a priority justifying the further investigation for potential biomarkers for its early diagnosis.
We aimed to investigate the diagnostic value of presepsin, procalcitonin, lactoferrin, interleukin (IL)-6, and IL-8 for the early diagnosis of EONS.
A prospective comparative study, including 30 cases with highly suspected EONS and 30 matched controls, was conducted. Besides the complete blood count and blood culture, C-reactive protein, procalcitonin, presepsin, IL-6, IL-8, and lactoferrin were measured at the admission and after 72 hours.
At the time of the admission, presepsin, procalcitonin, C-reactive protein, and IL-8 were significantly higher in the sepsis group. The levels of presepsin, procalcitonin, and IL-8 significantly decreased after 72 hours of the admission. Presepsin, procalcitonin, IL-8, and IL-6 showed a high diagnostic ability for sepsis at admission with area under the curve of 0.934, 0.798, 0.775, and 0.751, respectively. The cutoff values of presepsin, procalcitonin, IL-8, and IL-6 were 821 pg/mL, 2.3 ng/mL, 54 pg/mL, and 24 pg/mL, with a sensitivity of 88.9%, 72.2%, 83.3%, and 94.4% and specificity of 85.7%, 80.9%, 71.4%, and 52.4%, respectively. Lactoferrin had the lowest diagnostic ability with area under the curve of 0.558.
Presepsin was the most accurate biomarker followed by procalcitonin, IL-8, and IL-6 regarding the early diagnosis and management of EONS. The combination between these biomarkers is highly recommended.
Further studies are needed to investigate the diagnostic ability of the combination of these biomarkers.
Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Messrs Ahmed and Tarek Mohammed); Departments of Clinical Pathology (Dr Bastawy) and Pediatrics and Neonatology (Drs Attalla and Yousef), Faculty of Medicine, Helwan University, Helwan, Cairo, Egypt; Faculty of Medicine, Misr University for Science & Technology, Giza, Egypt (Ms Abdelrazek); Internal Medicine Department, Saint Joseph University Medical Center, Paterson, NJ, USA (Mr. Fransawy Alkomos); and Neuromuscular Research Unit, Neurology and Neuropsychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt (Mr Ghareeb).
Correspondence: Ali Mahmoud Ahmed, MBBCh, or Abdelrahman Tarek Mohammed, MBBCh, Faculty of Medicine, Al-Azhar University, Almokhayam aldaem St, Nasr city, Cairo, 11513, Egypt (email@example.com or firstname.lastname@example.org).
Ali Mahmoud Ahmed and Abdelrahman Tarek Mohammed contributed equally to the work.
The authors declare no conflicts of interest.