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Understanding the Difficulties in Diagnosing Neonatal Sepsis: Assessing the Role of Sepsis Biomarkers

Nicoleta Lungu

Nicoleta Lungu

Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and PharmacyTimișoara, Romania
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Lungu, Nicoleta
, 
Ana-Maria-Cristina Jura

Ana-Maria-Cristina Jura

University of Medicine and Pharmacy Victor Babes TimisoaraTimisoara, Romania
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Jura, Ana-Maria-Cristina
, 
Daniela-Eugenia Popescu

Daniela-Eugenia Popescu

Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and PharmacyTimișoara, Romania
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Popescu, Daniela-Eugenia
, 
Florin George Horhat

Florin George Horhat

Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and PharmacyTimișoara, Romania
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Horhat, Florin George
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Aniko Maria Manea

Aniko Maria Manea

Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and PharmacyTimișoara, Romania
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Manea, Aniko Maria
 and 
Marioara Boia

Marioara Boia

Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and PharmacyTimișoara, Romania
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Boia, Marioara
  
Oct 31, 2024
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Article Category: Research Article
Published Online: Oct 31, 2024
Page range: 316 - 328
Received: Jul 01, 2024
Accepted: Sep 10, 2024
DOI: https://doi.org/10.2478/jccm-2024-0039
Keywords
© 2024 Nicoleta Lungu et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1.

Comparative Diagnostic Performance of Biomarkers and laboratory findings in Participant Groups: Specificity and Sensitivity Analysis through ROC Curve Evaluations; A – ROC curve for C-reactive protein; B – ROC curve for procalcitonin; C – ROC curve for leukocytes; D – ROC curve for platelets; E – ROC curve for neutrophils; F – ROC curve for LDH; G – ROC curve for ferritin.
Comparative Diagnostic Performance of Biomarkers and laboratory findings in Participant Groups: Specificity and Sensitivity Analysis through ROC Curve Evaluations; A – ROC curve for C-reactive protein; B – ROC curve for procalcitonin; C – ROC curve for leukocytes; D – ROC curve for platelets; E – ROC curve for neutrophils; F – ROC curve for LDH; G – ROC curve for ferritin.

Fig. 2.

Comparative analysis of biomarker profiles in EOS and LOS groups at different time points (24 and 72 hours after onset); A – Boxplot for C-reactive protein; B – Boxplot for procalcitonin; C – Boxplot for leukocytes; D – Boxplot for platelets; E – Boxplot for neutrophils; F – Boxplot for LDH; G – Boxplot for ferritin.
Comparative analysis of biomarker profiles in EOS and LOS groups at different time points (24 and 72 hours after onset); A – Boxplot for C-reactive protein; B – Boxplot for procalcitonin; C – Boxplot for leukocytes; D – Boxplot for platelets; E – Boxplot for neutrophils; F – Boxplot for LDH; G – Boxplot for ferritin.

Comparing the second values (at 24 hours after onset) using the two-sample Wilcoxon signed rank test_ Presented are the p-values_

Variables EOS vs Control (p-value) LOS vs Control (p-value) EOS vs LOS (p-value)
CRP 0.0015 0.000005 0.00001
Procalcitonin 0.00005 0.00001 0.741
Leukocyte 0.4655 0.254 0.926
Neutrophils 0.00001 0.000001 0.668
Platelets 0.0076 0.0008 0.956
LDH 0.0009 0.0006 0.130
Ferritin 0.00001 0.000001 0.063

Comparing the first and last measured values for continuous variables using the two-sample Wilcoxon signed rank test_ Presented are the p-values_

Variables EOS (p-value) LOS (p-value) Control (p-value)
CRP 0.787 0.798 0.029
Procalcitonin 0.081 0.934 0.739
Leukocyte 0.740 0.214 0.002
Neutrophils 0.245 0.942 0.144
Platelets 0.342 0.364 0.00001
LDH 0.006 0.00001 0.061
Ferritin 0.0002 0.0038 0.529

Descriptive statistics for patients with confirmed culture results_

Variables EOS LOS Overall
Negative blood culture 17 (48.57%) 4 (10.25%) 21
Positive blood culture 18 (51.43%) 35 (89.75%) 53
Microorganism for BC+ (positive blood culture)
Klebsiella spp 8 (44.4%) 15 (42.85%) 23
Escherichia coli 5 (27.78%) 4 (11.42%) 9
Staphyloccocus aureus 2 (11.12%) 2 (5.71%) 4
Enterobacter 1 (5.55%) 2 (5.71%) 3
Serratia marcescens 2 (11.12%) 6 (17.14%) 8
Enterococcus 0 (0%) 3 (8.57%) 3
Pseudomonas aeruginosa 0 (0%) 2 (5.71%) 2
Others 0 (0%) 1 (2.85%) 1

Descriptive statistics

Variables EOS LOS Control Overall
n= 35 (28.92%) 39 (32.23%) 47 (38.84%) 121
Delivery mode:
Vaginal 17 (24.6%) 13 (18.8%) 39 (56.5%) 69
Cesarian section 18 (35.3%) 25 (49.0%) 8 (15.7%) 51
GA
24–28 weeks 4 (44.4%) 4 (44.4%) 1 (11.1%) 9
29–32 weeks 8 (30.7%) 6 (23.1%) 12 (46.2%) 26
33–37 weeks 21 (33.8%) 19 (30.7%) 22 (35.5%) 62
>38 weeks 2 (8.3%) 10 (41.7%) 12 (50.0%) 24
Onset of sepsis1 18.3 (14.0) hours 13.0 (7.1) days

Relationship among the categorical variables_ The association between surgical intervention and the necessity of oxygen supplementation for LOS patients_

Variable Surgical interventions in LOS group (n=) p-value
No Yes
Oxygen therapy No 6 2 1
Yes 22 9
High flow nasal canula No 21 10 0.397
Yes 7 1
nCPAP No 27 9 0.189
Yes 1 2
nIPPV/nCPAP No 27 11 1
Yes 1 0
SIMV No 19 3 0.0344
Yes 9 8
Language:
English
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4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Internal Medicine, other, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine, Surgery, Surgery, other
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