Hincu Maura-Adelina, Gheorghe Liliana, Dimitriu Cristina, Paduraru Luminita, Zonda Gabriela, Andronic Dan-Constantin, Vasilache Ingrid-Andrada, Baean Luiza-Maria, Nemescu Dragos
Department of Mother and Child Care, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Surgical Department, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Diagnostics (Basel). 2025 May 26;15(11):1341. doi: 10.3390/diagnostics15111341.
: Neonatal early-onset sepsis (EOS) is a life-threatening condition, and numerous efforts have been invested in identifying the most promising biomarkers for its detection. In this prospective cohort study, we aimed to determine the diagnostic accuracy and optimal cut-off values of procalcitonin (PCT), presepsin, endocan, and interleukin (IL)-6 determined from the neonatal serum (0-12, 24-48, and 72-96 h), and umbilical blood cord for the diagnosis of EOS. : A total of 122 patients were included in this study and were divided into two groups: group 1 (sepsis, n = 68 patients) and group 2 (without sepsis, n = 54 patients). Maternal and neonatal characteristics were assessed using descriptive statistics. Logistic regressions were used to evaluate the association between various biomarkers and the presence of EOS and to adjust for potential confounders. Using sensitivity analysis and Youden's index from the ROC curve, the biomarkers' diagnostic accuracy and optimal cut-off values were obtained. : PCT at 0-12 and 24-48 h of life exhibited the best diagnostic performance, with sensitivities (Ses) of 75% and 76.5% and specificities (Sps) above 74%. Presepsin demonstrated excellent performance at 24-48 h, with Ses of 68.42%, and Sps of 88.89%. IL-6 and endocan achieved modest results for the detection of EOS. : PCT and presepsin measured at early neonatal timepoints demonstrated high diagnostic accuracy and favorable sensitivity-specificity balance for predicting EOS.
新生儿早发型败血症（EOS）是一种危及生命的疾病，人们已投入大量精力来寻找最有前景的检测生物标志物。在这项前瞻性队列研究中，我们旨在确定从新生儿血清（0 - 12小时、24 - 48小时和72 - 96小时）以及脐带血中检测降钙素原（PCT）、可溶性髓系细胞触发受体-1（ presepsin）、内皮糖蛋白（endocan）和白细胞介素（IL）-6对EOS诊断的准确性及最佳临界值。
本研究共纳入122例患者，分为两组：第1组（败血症组，n = 68例患者）和第2组（无败血症组，n = 54例患者）。使用描述性统计评估母婴特征。采用逻辑回归评估各种生物标志物与EOS存在之间的关联，并对潜在混杂因素进行校正。通过敏感性分析和ROC曲线的约登指数，获得生物标志物的诊断准确性和最佳临界值。
出生后0 - 12小时和24 - 48小时的PCT表现出最佳诊断性能敏感性分别为75%和76.5%，特异性均高于74%。Presepsin在24 - 48小时表现出色，敏感性为68.42%，特异性为88.89%。IL - 6和endocan在EOS检测中取得了中等结果。
在新生儿早期时间点测量的PCT和presepsin对预测EOS具有较高的诊断准确性和良好的敏感性 - 特异性平衡。
