Biochemical markers of neonatal sepsis

The use of biochemical markers in neonatal infection has remained an important area of research in the past decades. Many infection markers are components of the inflammatory cascade and reflect the host's immunological status and response to infection. Cytokines and chemokines such as interleukin (IL)-6 and IL-8 have been demonstrated to have good diagnostic utilities as early phase markers, while acute phase reactants such as C-reactive protein and procalcitonin have superior diagnostic properties during the later phases. Other markers, including inter-alpha-inhibitor proteins, IL-10 and regulated upon activation normal T cells expressed and secreted (RANTES) have been demonstrated to yield important prognostic information and may help the clinician identify infants who will develop fulminant infection from the outset of presentation. The advent of flow cytometry and molecular techniques have made crucial contributions to the field and promise to further improve the diagnostic accuracy and clinical management of infected infants.