Neutrophil CD11b and serum procalcitonin as promising markers for early detection of neonatal sepsis.

Abstract

Although many biomarkers were used for diagnosing neonatal sepsis, none of them is conclusive alone. So, measuring multiple biomarkers were proposed to help in rapid diagnosis of neonatal sepsis. This study aimed to assess the potential role of measurement of neutrophil CD11b and serum procalcitonin (PCT) for early diagnosis of neonatal sepsis. This was a case control study, included 96 neonates admitted to Ain Shams University hospital. The neonates were divided into 3 Groups: Group A included proven sepsis Group with positive blood cultures (n=31), Group B, suspected Group with persistent clinical signs of sepsis but with negative blood cultures (n=36) and a control Group of normal newborns of matched age and sex (n=29). There was a statistically significant increase in expression of CD11b on neutrophils in Group A (median= 99.7) when compared with that of Group B (median= 99.4) and the control Group (median= 96.2) (p < 0.001), with increased mean fluorescence intensity in Group A (median= 21.3) when compared with that of Group B (median= 10.1) and control Group (median= 4.1) (p < 0.001). The receiver operating characteristic curve analysis was applied to assess the diagnostic performance of the tested markers. It showed that the serum PCT level can be used to discriminate between Group A and the control Group with 100% sensitivity, 100% specificity and CD 11b showed 100% sensitivity, 69% specificity. Moreover, to discriminate between Group A and Group B serum PCT showed 100% sensitivity, 88.9% specificity and CD 11b showed 87.1% sensitivity and 44.4% specificity. In conclusion, PCT and neutrophil CD11b are promising markers for diagnosis of early neonatal sepsis in preterm neonate.