Er Ilkay, Arpa Medeni
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize 53020, Turkey.
Department of Medical Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize 53020, Turkey.
Children (Basel). 2025 Jul 15;12(7):931. doi: 10.3390/children12070931.
: Early and accurate diagnosis of neonatal sepsis remains a clinical challenge due to nonspecific signs and limitations of conventional biomarkers. The immature platelet fraction (IPF), a novel hematologic parameter reflecting thrombopoietic activity, has emerged as a potential early sepsis indicator. This study aimed to evaluate the diagnostic value of IPF in neonatal sepsis prior to the onset of thrombocytopenia. : This prospective study enrolled neonates with early-onset sepsis (EOS), late-onset sepsis (LOS), and healthy controls. IPF, C-reactive protein (CRP), procalcitonin (PCT), and hematologic indices were measured at diagnosis and 48-72 h post-treatment. Diagnostic performance was evaluated via ROC curve analysis, and correlations between IPF and inflammatory/hematologic markers were examined. IPF levels were also compared based on blood culture results. : IPF levels were significantly higher in both EOS (n: 56) and LOS (n: 50) groups compared to controls (n: 44) ( < 0.001). ROC analysis showed excellent diagnostic performance, with AUCs of 0.98 (EOS) and 0.99 (LOS). Following antibiotic treatment, IPF levels declined significantly ( < 0.001), supporting its dynamic value. Strong and moderate correlations were found with MPV and CRP, respectively, and an inverse association with platelet count, but not with PCT. Moreover, IPF levels were higher in culture-positive cases compared to culture-negative ones (13.1% vs. 9.8%; = 0.017) and exhibited diagnostic performance comparable to CRP in predicting blood culture positivity. : This study presents original and clinically relevant data supporting IPF as a promising and practical hematologic biomarker for early detection and treatment monitoring of neonatal sepsis. Its integration into standard sepsis evaluation protocols may improve early risk stratification and clinical decision-making in neonatal intensive care settings.
由于新生儿败血症的非特异性体征以及传统生物标志物的局限性，早期准确诊断仍然是一项临床挑战。未成熟血小板分数（IPF）是一种反映血小板生成活性的新型血液学参数，已成为潜在的早期败血症指标。本研究旨在评估IPF在血小板减少症发作前对新生儿败血症的诊断价值。 ：这项前瞻性研究纳入了早发型败血症（EOS）、晚发型败血症（LOS）的新生儿以及健康对照。在诊断时和治疗后48 - 72小时测量IPF、C反应蛋白（CRP）、降钙素原（PCT）和血液学指标。通过ROC曲线分析评估诊断性能，并检查IPF与炎症/血液学标志物之间的相关性。还根据血培养结果比较了IPF水平。 ：与对照组（n = 44）相比，EOS组（n = 56）和LOS组（n = 50）的IPF水平均显著更高（<0.001）。ROC分析显示诊断性能优异，EOS的AUC为0.98，LOS的AUC为0.99。抗生素治疗后，IPF水平显著下降（<0.001），支持其动态价值。分别与平均血小板体积（MPV）和CRP存在强相关性和中度相关性，与血小板计数呈负相关，但与PCT无关。此外，培养阳性病例的IPF水平高于培养阴性病例（13.1%对9.8%；P = 0.017），并且在预测血培养阳性方面表现出与CRP相当的诊断性能。 ：本研究提供了原始且具有临床相关性的数据，支持IPF作为一种有前景且实用的血液学生物标志物，用于新生儿败血症的早期检测和治疗监测。将其纳入标准的败血症评估方案可能会改善新生儿重症监护环境中的早期风险分层和临床决策。
