Abstract
Neonatal sepsis (NS) is defined as a presence of microorganisms in primarily sterile body fluids and a presence of clinical and/or laboratory signs of a systemic inflammatory response. Given that clinical signs of sepsis are non-specific and the sensitivity of blood culture is low, biological indicators (biomarkers) of infection are essential for the diagnosis and rational therapy of NS.
In this comprehensive paper authors present the current possibilities of determining biomarkers in the diagnosis of NS. Commonly used biomarkers are changes in leukocyte and neutrophil counts, C-reactive protein, procalcitonin and interleukin-6.
However, sensitivity and specificity of these standard markers are relatively low in the first hours after birth. Biomarkers of NS that are under intensive reasearch are acute-phase proteins, cytokines, leukocyte surface antigens and their soluble forms.
Recent studies present the possibility of diagnosing infection by detecting extracellular vesicles (apoptotic bodies, microparticles, exosomes), which are released by cells after exposure to various stress signals, including infection. The aim of the comprehensive paper is to evaluate the standard biomarkers of NS and presentation of new biomarkers that have the potential to refine the diagnosis and therapy of NS.