Detection of soluble triggering receptor expressed on myeloid cell1 for diagnosis of earlyonset neonatal sepsis

Abstract

Objective To assess the clinical value of serum soluble triggering receptor expressed on myeloid cell–1 (sTREM–1) for diagnosis of early–onset neonatal sepsis (EONS). Methods A total of 90 neonatal cases with risk factors or symptoms of bacterial infections were enrolled in the study.All infants were admitted to Huai’an Maternity and Child Healthcare Hospital within 24 h after birth during January and June 2014. The enrolled neonates were divided into sepsis group (n＝33), general infection group (n＝23) and non–infected group (n＝34); and the sepsis group was further divided into culture–confirmed group (n＝6) and clinical–diagnosed group (n＝27). Twenty healthy neonates were also enrolled as the healthy control group. Blood samples were obtained from neonatal patients on d1, d3 and d7 after birth, and for healthy controls, the blood samples were only obtained at the first day. Serum levels of sTREM–1 and interleukin (IL)–6 were measured by double–antibody sandwich enzyme–linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was applied to evaluate the values of sTREM–1 and IL–6 in diagnosis of EONS. Results Compared with that in general infection group, non–infected group and healthy control group, the serum level of sTREM–1 was significantly higher in sepsis group (all P＜0.05); serum levels of sTREM–1 in general infection group and non–infected group were also higher than that in healthy control group (all P＜0.05); but no difference was observed between general infection group and non–infected group, between culture–confirmed group and clinical–diagnosed group (P＞0.05). Serum level of sTREM–1 showed upward trend during d1–3 after the birth, and downward trend during d3–7. The areas under the ROC curve (AUC) were 0.810 and 0.811 (all P < 0.05) for sTREM–1 levels on d1 and d3 in diagnosis of EONS, and the optimal cut–off values were 234.44 ng/L and 269.79 ng/L, respectively. If sTREM–1 and IL–6 on d1 were combined for diagnosis of EONS, the AUC, sensitivity and specificity were 0.858, 92.00% and 93.10%, respectively. Conclusion Serum level of sTREM–1 in early stage is valuable for diagnosis of EONS, and the combined use of serum sTREM–1 and IL–6 may improve the diagnostic value. Key words: Infant, newborn; Sepsis; Soluble triggering receptor expressed on myeloid cell–1; Interleukin–6; Diagnosis