Department of Pediatrics, University Hospital of Ioannina, 45500 Ioannina, Greece.
Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece.
Int J Mol Sci. 2024 Feb 13;25(4):2258. doi: 10.3390/ijms25042258.
Early-onset sepsis (EOS) is a global health issue, considered one of the primary causes of neonatal mortality. Diagnosis of EOS is challenging because its clinical signs are nonspecific, and blood culture, which is the current gold-standard diagnostic tool, has low sensitivity. Commonly used biomarkers for sepsis diagnosis, including C-reactive protein, procalcitonin, and interleukin-6, lack specificity for infection. Due to the disadvantages of blood culture and other common biomarkers, ongoing efforts are directed towards identifying innovative molecular approaches to diagnose neonates at risk of sepsis. This review aims to gather knowledge and recent research on these emerging molecular methods. PCR-based techniques and unrestricted techniques based on 16S rRNA sequencing and 16S-23S rRNA gene interspace region sequencing offer several advantages. Despite their potential, these approaches are not able to replace blood cultures due to several limitations; however, they may prove valuable as complementary tests in neonatal sepsis diagnosis. Several microRNAs have been evaluated and have been proposed as diagnostic biomarkers in EOS. T2 magnetic resonance and bioinformatic analysis have proposed potential biomarkers of neonatal sepsis, though further studies are essential to validate these findings.
早发性败血症（EOS）是一个全球性的健康问题，被认为是新生儿死亡的主要原因之一。EOS 的诊断具有挑战性，因为其临床症状不具有特异性，而目前的金标准诊断工具——血液培养，其灵敏度较低。常用于败血症诊断的生物标志物，包括 C 反应蛋白、降钙素原和白细胞介素-6，对感染缺乏特异性。由于血液培养和其他常见生物标志物的缺点，目前正在努力寻找创新的分子方法来诊断有败血症风险的新生儿。本综述旨在收集关于这些新兴分子方法的知识和最新研究。基于 PCR 的技术和基于 16S rRNA 测序和 16S-23S rRNA 基因间隔区测序的无限制技术具有几个优势。尽管它们具有潜力，但由于存在一些限制，这些方法不能替代血液培养；然而，它们可能在新生儿败血症诊断中作为补充测试具有重要价值。已经评估了几种 microRNAs，并被提出作为 EOS 的诊断生物标志物。T2 磁共振和生物信息学分析提出了新生儿败血症的潜在生物标志物，但需要进一步的研究来验证这些发现。
