Zonda Gabriela Ildiko, Zonda Radu, Cernomaz Andrei Tudor, Paduraru Luminita, Avasiloaiei Andreea Luciana, Grigoriu Bogdan Dragos
Division of Neonatology, Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania.
"Petru Poni" Institute of Macromolecular Chemistry, Iași, Romania.
J Infect Dev Ctries. 2019 Apr 30;13(4):311-317. doi: 10.3855/jidc.11202.
Neonatal early onset sepsis assessment is based on the history of pregnancy and delivery and nonspecific clinical signs. None of the biomarkers currently in use for clinical practice has adequate prognostic value, so it is not possible to clearly distinguish neonates with culture-proven sepsis from those with only risk factors or clinical suspicion. Endocan is an endothelial mediator involved in the inflammatory response that is present in low concentrations in the serum of healthy subjects, and in much higher concentrations in patients with SIRS and septic shock. The purpose of this study is to evaluate the utility of serum endocan serum levels as a biomarker for the diagnosis of neonatal early onset sepsis (EOS).
Serum endocan concentration was measured in newborns with clinical suspicion of EOS admitted to the Neonatal Intensive Care Unit on day 1, 3 and 7.
Serum endocan levels were significantly increased in septic compared to non-septic neonates in the early stages of sepsis (2.43 ± 0.95 vs. 1.77 ± 0.57, p = 0.004), continued to rise up to 72 hours from onset and then decreased by the seventh day under treatment.
These results suggest a potential role for endocan as an early marker for diagnosis and follow-up in neonatal EOS. Studies on a larger number of cases are needed in order to establish the practical utility of this molecule as a diagnostic tool for clinical practice.
新生儿早发型败血症的评估基于妊娠和分娩史以及非特异性临床体征。目前临床实践中使用的生物标志物均无足够的预后价值，因此无法明确区分经培养证实患有败血症的新生儿与仅有风险因素或临床疑似病例的新生儿。内脂素是一种参与炎症反应的内皮介质，在健康受试者血清中浓度较低，而在全身炎症反应综合征（SIRS）和感染性休克患者中浓度则高得多。本研究的目的是评估血清内脂素水平作为新生儿早发型败血症（EOS）诊断生物标志物的效用。
对入住新生儿重症监护病房、临床疑似EOS的新生儿在第1天、第3天和第7天测量血清内脂素浓度。
在败血症早期，败血症新生儿的血清内脂素水平显著高于非败血症新生儿（2.43±0.95 vs. 1.77±0.57，p = 0.004），从发病起持续上升至72小时，然后在治疗第7天时下降。
这些结果表明内脂素在新生儿EOS诊断和随访中作为早期标志物具有潜在作用。需要对更多病例进行研究，以确定该分子作为临床实践诊断工具的实际效用。
