engleski

Can CD15s (sialyl Lewis x) be used as a potential marker for neonatal sepsis? Control study. Split, Croatia

Objective: Neonatal sepsis carries a high mortality when diagnosed late. Early diagnosis is difficult because initial clinical signs are nonspecific. Consequently, physicians frequently prescribe antibiotic treatment to newborn infants for fear of missing a lifethreatening infection. Current biomarkers are not infallible, however, and do not permit neonatologists to withhold antibiotics in sick neonates with suspected infection. In response to infection, circulating leukocytes tether to the vessel wall and then roll. Only certain adhesion molecules including (E) selectins and some integrins have been found to support rolling. E-selectins bind to carbohydrate ligands on leukocytes in which the sialyl Lewis x (sLex, CD15s) moiety is of key importance. The aim of this pilot study was to determine a diagnostic value of CD15s in detection of early onset neonatal sepsis.Methods: A total of 25 neonates born in minimum 37th gestation week and <72 hours before sampling were enrolled in the study. One group of neonates had clinical signs or obstetric risk factors suggesting neonatal sepsis. The control group included healthy neonates with physiological hyperbilirubinemia and without clinical signs of infection. The percentage of CD15s+ leukocytes was measured by flow cytometry using monoclonal antibody. Data were analyzed using WinMDI v.2.9 software. Statistical differences among the groups were analyzed by t-test using MedCalc v.12.5 software. Results: Statistically significant differences in percentage of CD15s+ total leukocytes, monocytes and granulocytes were observed between control and case group. We found an increased percentage of CD15s+ monocytes and granulocytes in neonates with suspected sepsis (P < 0.0001 and P = 0.0338, respectively). There was no statistically significance in percentage of CD15s+ total leukocytes between groups. Conclusions: Recent research in immunology has led to the discovery of cell surface antigens, chemokines, cytokines and acute phase proteins that can potentially be used to ‘rule in’ or ‘rule out’ sepsis. These preliminary data show that CD15s has a diagnostic potential for an early identification of neonatal sepsis. Further studies with greater number of samples are required for potential inclusion of this marker in the currently used screening panels for the early diagnosis or the infection treatment in the neonates.

Neonatal sepsis, Biomarkers, CD15s

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