Potential biomarkers for diagnosing neonatal sepsis

Vulnerable population of neonates has suboptimal immune function that results toward their susceptibility to infection and sepsis-related mortality. Till date, neonatal innate immunity has not been completely understood, yet molecular characterization of this complex system has paved a path for identifying biomarkers that hold the potential to aid clinicians in diagnosing sepsis. The last decade has seen emergence of multiple putative biomarkers for early detection of neonatal sepsis. These include surface markers, acute phase reactants, cytokines, and chemokines. Analysis of these components has led us to the conclusion that biological factors/molecules have the potential to identify the sepsis progression in neonates. Early-onset sepsis can be detected by C-reactive protein, procalcitonin, and soluble triggering receptor expressed on myeloid cells-1. On the other hand, specific neutrophil and monocyte markers (cluster of differentiation 64 and toll-like receptors) along with the soluble urokinase-type plasminogen activator receptor can effectively detect late-onset sepsis. These markers need to be validated by conducting multicenter clinical trials with target of enrolling more number of neonates so that statistically effective biomarkers could be identified.