"Advancements in Biomarkers for Early Diagnosis and Management of Neonatal Sepsis: Insights into Oxidative Stress, Inflammatory Markers, and Novel Biomarkers"

Abstract

Introduction:  Neonatal sepsis presents a critical challenge in clinical practice, requiring swift identification and intervention to mitigate its potentially devastating effects. Recent advancements in understanding its pathophysiology have led to the development of biomarkers as crucial tools for aiding clinical decision-making. This review focuses on recent progress in biomarkers for diagnosing and managing neonatal sepsis, particularly emphasizing the roles of Procalcitonin (PCT), Neutrophil Gelatinase Associated Lipocalin (NGAL), and C-reactive protein (CRP) in conjunction with oxidative stress and inflammatory markers. Objectives: Assess the diagnostic efficacy of Procalcitonin (PCT), Neutrophil Gelatinase Associated Lipocalin (NGAL), and C-reactive protein (CRP) in distinguishing between bacterial and non-bacterial causes of neonatal sepsis.Methods: This case-control study was conducted at the Department of Biochemistry, in collaboration with the Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College & Hospital, Sangli, from February 2015 to August 2017. A total of 140 neonates were included, comprising 70 clinically suspected sepsis cases and 70 healthy controls. Blood samples were collected from each subject, and various markers including CRP, PCT, Neutrophil Gelatinase Associated Lipocalin (NGAL).Results: The review found that Procalcitonin (PCT), Neutrophil Gelatinase Associated Lipocalin (NGAL), and C-reactive protein (CRP) exhibit promising diagnostic utility in distinguishing between bacterial and non-bacterial etiologies of neonatal sepsis. Elevated concentrations of these biomarkers were consistently observed in septic neonates compared to non-septic controls. Conclusions: Through a comprehensive discussion, the review elucidated the distinct roles of PCT, CRP, and NGAL in the pathophysiology of neonatal sepsis. These biomarkers were found to be associated with inflammation, tissue injury, and modulation of microbial growth, underscoring their multifaceted contributions to the disease process. Overall, the results of this study suggest that PCT, CRP, and NGAL hold promise as valuable biomarkers for improving outcomes in neonatal sepsis. Their integration into clinical practice has the potential to enhance early diagnosis, facilitate prompt intervention, and ultimately mitigate the devastating consequences of this challenging condition.