Endocan and Soluble Triggering Receptor Expressed on Myeloid Cells-1 as Novel Markers for Neonatal Sepsis.
BACKGROUND
Neonatal sepsis is an important cause of neonatal morbidity and mortality in the neonatal intensive care unit. Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has been evaluated in sepsis and septic shock, and it was found to be valuable in distinguishing septic cases from nonseptic cases. Endocan is constitutively expressed by endothelial cells, and high levels of endocan may be of relevance for the promotion of systemic inflammation. The aim of this study was to investigate whether the levels of sTREM-1 and endocan were increased in late-onset neonatal sepsis.


METHODS
Patients were classified into septic and nonseptic groups. Blood was collected from a peripheral vein of all septic newborns and healthy newborns at the time of initial laboratory evaluation before any treatment, and within 48-72 hours after initiation of treatment. Serum sTREM-1 and endocan measurements were performed when the study was finished.


RESULTS
The study population comprised of 50 neonates: 20 nonseptic neonates and 30 septic neonates. The groups were similar with regards to baseline characteristics. The initial measurements of interleukin-6 (IL-6), sTREM-1, endocan, and immature/total neutrophil ratio (I/T ratio) were significantly higher in septic neonates in comparison with nonseptic neonates. Receiver operating characteristic (ROC) curve analyses revealed that IL-6, sTREM-1, endocan, and I/T ratio resulted in significant areas under the curve (AUC) with respect to early identification of septic neonates. Soluble TREM-1 and IL-6 performed best to distinguish septic neonates from nonseptic neonates. Univariate logistic regression analysis showed that increased IL-6 and sTREM-1 were strong predictors of neonatal late-onset sepsis.


CONCLUSIONS
Serum sTREM-1, IL-6, endocan levels, and I/T ratio increased in septic neonates. However, the diagnostic accuracy of circulating sTREM-1 seemed to be better than endocan and I/T ratio, but lower than IL-6.
Department of Pediatrics, Gulhane Military School of Medicine, Ankara, Turkey.
Mehmet
M
Saldir
Department of Pediatrics, Division of Neonatology, Gulhane Military School of Medicine, Ankara, Turkey. Electronic address: ttunc@gata.edu.tr.
Turan
T
Tunc
Department of Pediatrics, Division of Neonatology, Gulhane Military School of Medicine, Ankara, Turkey.
Ferhat
F
Cekmez
Department of Pediatrics, Division of Neonatology, Istanbul Kanuni Sultan Suleyman Teaching Hospital, Istanbul, Turkey.
Merih
M
Cetinkaya
Department of Pediatrics, Division of Neonatology, Istanbul Kanuni Sultan Suleyman Teaching Hospital, Istanbul, Turkey.
Tugce
T
Kalayci
Department of Pediatrics, Gulhane Military School of Medicine, Ankara, Turkey.
Kursat
K
Fidanci
Department of Pediatrics, Gulhane Military School of Medicine, Ankara, Turkey.
Oguzhan
O
Babacan
Department of Pediatrics, Gulhane Military School of Medicine, Ankara, Turkey.
Galip
G
Erdem
Department of Public Health, Gulhane Military School of Medicine, Ankara, Turkey.
Necmettin
N
Kocak
Department of Pediatrics, Gulhane Military School of Medicine, Ankara, Turkey.
Erkan
E
Sari
Department of Clinical Biochemistry, Gulhane Military School of Medicine, Ankara, Turkey.
Emin Ozgur
EO
Akgul
Department of Pediatrics, Gulhane Haydarpasa Military Hospital, Istanbul, Turkey.
Mustafa
M
Kul
D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D000071074:Neonatal Sepsis / Q000097:blood*; D009363:Neoplasm Proteins / Q000097:blood*; D011446:Prospective Studies; D011509:Proteoglycans / Q000097:blood*; D011971:Receptors, Immunologic / Q000097:blood*; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
D015415:Biomarkers; C101134:ESM1 protein, human; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D009363:Neoplasm Proteins; D011509:Proteoglycans; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
biomarker; endocan; neonatal intensive care; newborn; sTREM-1; sepsis