Zdorovʹe Rebenka (Apr 2023)

Some immunological biomarkers of the severity of neonatal sepsis in newborns depending on different inflammatory response

  • O.K. Koloskova,
  • N.K. Bogutska,
  • O.V. Vlasova,
  • S.I. Tarnavska,
  • O.O. Shakhova

DOI
https://doi.org/10.22141/2224-0551.18.2.2023.1573
Journal volume & issue
Vol. 18, no. 2
pp. 127 – 134

Abstract

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Background. Objective: to study the diagnostic value and indicators of clinical and epidemiological risk of some immunological biomarkers as indicators of the severity of the clinical course of neonatal sepsis in order to improve treatment outcomes in newborns with neonatal sepsis with an alternative serum content of C-reactive protein. Materials and methods. A comprehensive clinical and paraclinical examination of 56 children with neonatal sepsis was conducted. The severity of neonatal sepsis was determined using the constellation-diagnostic scales of multiple organ dysfunction such as SNAPII, SNAPРЕII, PELOD, SOFA, ­nSOFA, PEMOD, SCRIB, NEOMOD. The comprehensive immunological examination with evaluation of immunoglobulin A, G, M, C-reactive protein, presepsin, procalcitonin, interleukins (IL) 6, 8, 10 content in blood serum was conducted in all newborns. Two clinical groups were formed. The clinical group I included 25 infants with neonatal sepsis with a serum level of C-reactive protein 20 mg/l (with 62.8 % of boys, p > 0.05; 57.1 % of city residents, p > 0.05; the average content of C-reactive protein — 29.70 ± 1.89 mg/l, р 31.4 pg/ml (relative risk (RR) 1.7 (95% confidence interval (CI): 1.3–2.2) with an odds ratio (OR) 2.8 (95% CI: 1.6–5.1)), IL-10 > 18 pg/ml (RR 1.7 (95% CI: 1.1–2.4) with an OR 2.9 (95% CI: 1.6–5.3)), and IL-8 > 24.0 pg/ml (RR 1.9 (95% CI: 1.2–3.1) with an OR 4.7 (95% CI: 2.5–8.8)). Among the studied immunological biomarkers, the concentration of presepsin > 1,000 ng/ml was accompanied by the best indicators of the clinical and epidemiological risk of severe sepsis according to the constellation-diagnostic scales of multiple organ dysfunction (odds ratio 4.3–6.0, relative risk 2.3–2.5, attributable risk 32.0–42.0 %). Conclusions. Elevated content of some markers of neonatal sepsis (presepsin, procalcitonin) and interleukins (IL-6, IL-8) can be considered a biomarker of a severe course of neonatal sepsis with probable development of multiple organ dysfunction.

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