The clinical significance of sCD14-ST for blood biomarker in neonatal hematosepsis

Abstract

Hematosepsis is a systemic inflammatory response syndrome (SIRS) with suspected or confirmed infection, which is the most common infectious disease in clinical neonatal intensive care unit. As the rapid development of neonatal hematosepsis caused by various basic diseases, the mortality rate is high, and there are some sequelae.We report the lasted study to date with 96 cases from Fujian Longyan First Hospital between 2013 and 2015. The aim of our study is to explore the value of soluble cluster of differentiation 14 subtype (sCD14-ST) in whole blood for differential diagnosis of neonatal hematosepsis at an early stage, and used in evaluation of the severity about sepsis combined with acute physiology and chronic health evaluation II (APACHE-II) score, procalcitonin (PCT), C reactive protein (CRP), and leukocyte (WBC).In our cohort, all cases met the diagnostic criteria for hematosepsis specific for newborns. We selected 42 neonates with hematosepsis, 54 neonates with nonhematosepsis, 44 noninfectious SIRS neonates, and 53 healthy neonatal controls. Which were determined the sCD14-ST, PCT, CRP, and WBC of all samples before treatment. Then assign the APACHE-II score for the all samples before and after treatment.The study shows, sCD14-ST levels were significantly higher in hematosepsis than nonhematosepsis group (t = −2.112, P = .041). Meanwhile, sCD14-ST levels were significantly higher in neonatal hematosepsis than in noninfectious SIRS group and controls (χ2 = 57.812, 68.944, P < .01). However, sCD14-ST in hematosepsis group was positively correlated with APACHE-II score (R-value = 0.415, P < .01). During treatment, the sCD14-ST level was decreased obviously along with APACHE-II score, PCT, CRP, and WBC (χ2 = 35.019, 78.399, 52.363, 25.912, 7.252, all P values <.01). The area under the curve (AUC) of sCD14-ST was 0.942. The differences in ROCAUC of sCD14-ST compared with PCT, CRP, and WBC were statistically significant (Z = −6.034, −4.474, −5.722, all P values <.01). The sensitivity and specificity of sCD14-ST were 95.2% and 84.9%, respectively.sCD14-ST could be a blood biomarker for early identification and disease valuation in newborns hematosepsis infection; and its diagnostic value is superior to other laboratory indexes.

The Utility of Soluble CD14 Subtype in Early Diagnosis of Culture-Proven Early-Onset Neonatal Sepsis and Prediction of Outcome

“…30 Our study reports that there was a significant decline in the sCD14-ST levels of the septic neonates on day 3. Our findings were in accordance with the results of previous studies by Montaldo et al 22 Also, Topcuoglu et al in lateonset sepsis study reported similar findings. 29 Our study showed that there was no significant difference in sCD14-ST levels between gram-positive bacterial group and gram-negative bacterial group.…”

“…The median (IQR) initial Tollner's score was 10 (8.5-12). The mean duration of inotropic support in shocked neonates was 7.2 AE 1.82 days, the median (IQR) duration of ventilation was 8 (5-9) days, and the median (IQR) duration of NICU admission was 20 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) days. ►Table 2 shows that neonates who needed mechanical ventilation had higher serum sCD14-ST levels on day 1 than those who did not need mechanical ventilation (p ¼ 0.001)…”

“…There were significantly higher presepsin serum levels in culture-proven versus probable sepsis group (p < 0.05 for all). 22 Montaldo et al reported that presepsin values were significantly higher in the EOS group than in the uninfected group at different times. The best accuracy for prediction of EOS was at 24 hours of age.…”

Biomarkers for Point-of-Care Diagnosis of Sepsis

“…It is interesting to note that they also calculated AUCs for CRP (0.8580) and PCT (0.7831), indicating superior performance of presepsin over both (and of CRP over PCT). Similarly high performance of presepsin was demonstrated in individual studies by Montaldo and co-workers [79], with an AUC of 0.97, and Xian and colleagues [80], who reported an AUC of 0.942. A recent study by Deǧirmencioǧlu and co-workers [81] calculated an AUC of 0.939 for the diagnosis of late-onset sepsis in preterm neonates, which was slightly outperformed by IL-6 (AUC of 0.959).…”

Soluble CD14 subtype (sCD14-ST) as biomarker in neonatal early-onset sepsis and late-onset sepsis: a systematic review and meta-analysis

“…In EOS an increase in sCD14-ST plasma levels is seen in the first 24 h [9], in contrast to LOS [10]. After treatment initiation sCD14-ST levels decrease in the next few days in both EOS and LOS [9–13]. In order to evaluate the differences between EOS and LOS and its influence on the diagnostic accuracy of sCD14-ST we performed a new meta-analysis of the current literature, analyzing EOS and LOS separately.…”