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Understanding the Difficulties in Diagnosing Neonatal Sepsis: Assessing the Role of Sepsis Biomarkers Cover

Understanding the Difficulties in Diagnosing Neonatal Sepsis: Assessing the Role of Sepsis Biomarkers

Open Access
|Oct 2024

Figures & Tables

Table 1.

Descriptive statistics

VariablesEOSLOSControlOverall
n=35 (28.92%)39 (32.23%)47 (38.84%)121
Delivery mode:
Vaginal17 (24.6%)13 (18.8%)39 (56.5%)69
Cesarian section18 (35.3%)25 (49.0%)8 (15.7%)51
GA
24–28 weeks4 (44.4%)4 (44.4%)1 (11.1%)9
29–32 weeks8 (30.7%)6 (23.1%)12 (46.2%)26
33–37 weeks21 (33.8%)19 (30.7%)22 (35.5%)62
>38 weeks2 (8.3%)10 (41.7%)12 (50.0%)24
Onset of sepsis118.3 (14.0) hours13.0 (7.1) days

1 For this variable we calculated the mean (with standard deviation). Notes: GA-gestational age., EOS-early onset sepsis, LOS-late onset sepsis.

Table 2.

Descriptive statistics for patients with confirmed culture results.

VariablesEOSLOSOverall
Negative blood culture17 (48.57%)4 (10.25%)21
Positive blood culture18 (51.43%)35 (89.75%)53
Microorganism for BC+ (positive blood culture)
Klebsiella spp8 (44.4%)15 (42.85%)23
Escherichia coli5 (27.78%)4 (11.42%)9
Staphyloccocus aureus2 (11.12%)2 (5.71%)4
Enterobacter1 (5.55%)2 (5.71%)3
Serratia marcescens2 (11.12%)6 (17.14%)8
Enterococcus0 (0%)3 (8.57%)3
Pseudomonas aeruginosa0 (0%)2 (5.71%)2
Others0 (0%)1 (2.85%)1
Fig. 1.

Comparative Diagnostic Performance of Biomarkers and laboratory findings in Participant Groups: Specificity and Sensitivity Analysis through ROC Curve Evaluations; A – ROC curve for C-reactive protein; B – ROC curve for procalcitonin; C – ROC curve for leukocytes; D – ROC curve for platelets; E – ROC curve for neutrophils; F – ROC curve for LDH; G – ROC curve for ferritin.

Table 3.

Comparing the first and last measured values for continuous variables using the two-sample Wilcoxon signed rank test. Presented are the p-values.

VariablesEOS (p-value)LOS (p-value)Control (p-value)
CRP0.7870.7980.029
Procalcitonin0.0810.9340.739
Leukocyte0.7400.2140.002
Neutrophils0.2450.9420.144
Platelets0.3420.3640.00001
LDH0.0060.000010.061
Ferritin0.00020.00380.529

[i] In bold are statistically significant differences. Notes: CRP-C reactive protein, LDH-Lactate dehydrogenase, EOS-early onset sepsis, LOS-late onset sepsis.

Fig. 2.

Comparative analysis of biomarker profiles in EOS and LOS groups at different time points (24 and 72 hours after onset); A – Boxplot for C-reactive protein; B – Boxplot for procalcitonin; C – Boxplot for leukocytes; D – Boxplot for platelets; E – Boxplot for neutrophils; F – Boxplot for LDH; G – Boxplot for ferritin.

Table 4.

Comparing the second values (at 24 hours after onset) using the two-sample Wilcoxon signed rank test. Presented are the p-values.

VariablesEOS vs Control (p-value)LOS vs Control (p-value)EOS vs LOS (p-value)
CRP0.00150.0000050.00001
Procalcitonin0.000050.000010.741
Leukocyte0.46550.2540.926
Neutrophils0.000010.0000010.668
Platelets0.00760.00080.956
LDH0.00090.00060.130
Ferritin0.000010.0000010.063

[i] In bold are statistically significant differences. Notes: CRP-C reactive protein, LDH-lactate dehydrogenase.

Table 5.

Relationship among the categorical variables. The association between surgical intervention and the necessity of oxygen supplementation for LOS patients.

VariableSurgical interventions in LOS group (n=)p-value
NoYes
Oxygen therapyNo621
Yes229
High flow nasal canulaNo21100.397
Yes71
nCPAPNo2790.189
Yes12
nIPPV/nCPAPNo27111
Yes10
SIMVNo1930.0344
Yes98

[i] In bold are statistically significant differences. Notes: nCPAP-nasal continuous positive airways pressure, nIPPV-Noninvasive positive pressure ventilation, SIMV-Synchronized intermittent Mandatory Ventillation.

DOI: https://doi.org/10.2478/jccm-2024-0039 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 316 - 328
Submitted on: Jul 1, 2024
Accepted on: Sep 10, 2024
Published on: Oct 31, 2024
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2024 Nicoleta Lungu, Ana-Maria-Cristina Jura, Daniela-Eugenia Popescu, Florin George Horhat, Aniko Maria Manea, Marioara Boia, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.