Serum YKL-40 as a Potential Biomarker for Sepsis in Term Neonates—A Pilot Study
Evangelia Steletou,
Dimitra Metallinou,
Alexandra Margeli,
Theodoros Giannouchos,
Athanasios Michos,
Christina Kanaka-Gantenbein,
Ioannis Papassotiriou,
Tania Siahanidou
Affiliations
Evangelia Steletou
Master of Science Program “Pediatric Infectious Diseases”, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
Dimitra Metallinou
Department of Midwifery, University of West Attica, 12243 Athens, Greece
Alexandra Margeli
Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Theodoros Giannouchos
Department of Health Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29150, USA
Athanasios Michos
First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Christina Kanaka-Gantenbein
First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Ioannis Papassotiriou
First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Tania Siahanidou
First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Although YKL-40 is a promising diagnostic biomarker of sepsis in adults, its value in neonatal sepsis is not known. The study objectives included assessing the levels and diagnostic value of serum YKL-40 in term neonates with sepsis and comparing YKL-40 with other commonly used inflammatory biomarkers. In this pilot case–control study, 45 term neonates (30 septic and 15 non-septic, as controls), 4 to 28 days old, were prospectively studied. The International Pediatric Sepsis Consensus Conference criteria were applied to diagnose sepsis. During the acute phase (admission) and remission of sepsis, blood samples were collected from cases (while from controls they were only collected once) for routine laboratory tests, cultures, and the measurement of serum YKL-40 levels via Elisa. In the acute phase of sepsis, YKL-40 levels were significantly elevated in comparison with remission (p = 0.004) and controls (p = 0.003). YKL-40 levels did not differ significantly between patients in remission and controls (p = 0.431). Upon admission, YKL-40 levels correlated positively with white blood count, absolute neutrophil count, and CRP levels. Via ROC analysis, it was shown that YKL-40 levels upon admission were a significant indicator of sepsis (AUC = 0.771; 95% CI 0.632–0.911; p = 0.003). Serum YKL-40 might be considered as an adjuvant biomarker of sepsis in term neonates.
