Untargeted 1H-NMR Urine Metabolomic Analysis of Preterm Infants with Neonatal Sepsis

Panagiota D Georgiopoulou,Georgios A Spyroulias,Styliani A Chasapi,Irene Christopoulou,Anastasia Varvarigou

doi:10.3390/app12041932

Panagiota D Georgiopoulou, Georgios A Spyroulias + Show 3 more

Open Access

https://doi.org/10.3390/app12041932

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Abstract

One of the most critical medical conditions occurring after preterm birth is neonatal sepsis, a systemic infection with high rates of morbidity and mortality, chiefly amongst neonates hospitalized in Neonatal Intensive Care Units (NICU). Neonatal sepsis is categorized as early-onset sepsis (EOS) and late-onset sepsis (LOS) regarding the time of the disease onset. The accurate early diagnosis or prognosis have hurdles to overcome, since there are not specific clinical signs or laboratory tests. Herein, a need for biomarkers presents, with the goals of aiding accurate medical treatment, reducing the clinical severity of symptoms and the hospitalization time. Through nuclear magnetic resonance (NMR) based metabolomics, we aim to investigate the urine metabolomic profile of septic neonates and reveal those metabolites which could be indicative for an initial discrimination between the diseased and the healthy ones. Multivariate and univariate statistical analysis between NMR spectroscopic data of urine samples from neonates that developed EOS, LOS, and a healthy control group revealed a discriminate metabolic profile of septic newborns. Gluconate, myo-inositol, betaine, taurine, lactose, glucose, creatinine and hippurate were the metabolites highlighted as significant in most comparisons.

Highlights

Academic Editor: Chiara CavaliereNeonatal sepsis is a systemic inflammatory response to infection, with a wide range and severity of symptoms [1]
Differentiated concentration levels of taurine and hippurate via LC-mass spectrometry (MS) analysis have been previously reported by Sarafidis et al, and through UPLC-MS by Mardegan et al [28,29]; our study was the first to detect them in urine samples of septic neonates via nuclear magnetic resonance (NMR)
The impact of nutrition is confirmed from the greatly elevated levels of gluconate for the septic group and lactose for neonates fed from their mothers

Summary

Introduction

Neonatal sepsis is a systemic inflammatory response to infection, with a wide range and severity of symptoms [1]. The incidence varies all over the world and is quite different among high-, low-, and middle-income countries [2]. Despite the progress in medical knowledge, neonatal care and antibiotic treatment, sepsis is considered one of the main reasons of morbidity and mortality, especially in very low birth weight (VLBW,

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