Diagnostic Utility of Endocan and Interleukins for Late-Onset Neonatal Sepsis

Preslava Gatseva, Alexander B. Blazhev, Zarko Y. Yordanov, Victoria G. Atanasova
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Abstract

Summary The aim of this study was to determine the potential of early inflammatory markers to diagnose late-onset neonatal sepsis – interleukin 6 (IL-6), interleukin 8 (IL-8) and endocan (ESM-1), and to compare them with routinely used markers like C-reactive protein (CRP) and procalcitonin (PCT). A prospective (January, 2022 – January, 2023) clinical-epidemiological study was conducted in a third level NICU in Pleven, Bulgaria. Patients with suspected nosocomial infection and healthy controls were tested. A sandwich ELISA method was used to measure the serum concentrations. Sixty newborns with an average gestational age of 29.75±3.61 gestational weeks were included, of which 35% were symptomatic and infected, 33.3% were symptomatic but uninfected, and 31.7% were asymptomatic controls. The mean values of PCT and IL-6 differ significantly in the three groups. For ESM-1, IL-8 and CRP, the difference was statistically insignificant. The best sensitivity (78%) and negative predictive value (84%) was found for IL-6. The introduction into routine practice of indicators such as PCT and IL-6 may provide an opportunity to promptly optimize the diagnostic and therapeutic approach to LOS.
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内毒素和白细胞介素对晚期新生儿败血症的诊断作用
摘要 本研究的目的是确定早期炎症标记物--白细胞介素 6(IL-6)、白细胞介素 8(IL-8)和内凝血因子(ESM-1)--诊断晚期新生儿败血症的潜力,并将它们与常规使用的标记物如 C 反应蛋白(CRP)和降钙素原(PCT)进行比较。一项前瞻性(2022 年 1 月至 2023 年 1 月)临床流行病学研究在保加利亚普列文的一家三级重症监护室进行。对疑似院内感染的患者和健康对照组进行了检测。采用夹心酶联免疫吸附法测定血清浓度。60 名新生儿的平均胎龄为 29.75±3.61 孕周,其中 35% 有症状并受到感染,33.3% 有症状但未受到感染,31.7% 为无症状对照组。PCT和IL-6的平均值在三组中差异显著。ESM-1、IL-8 和 CRP 的差异在统计学上不显著。IL-6的灵敏度(78%)和阴性预测值(84%)最佳。将 PCT 和 IL-6 等指标引入常规做法可为及时优化 LOS 的诊断和治疗方法提供机会。
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