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.