Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis

Area of Science:

• Neonatal Medicine
• Infectious Diseases
• Clinical Diagnostics

Background:

• Early-onset sepsis presents a significant diagnostic challenge in neonatal care.
• Definitive diagnosis relies on culturing normally sterile body fluids, which can be slow.
• Hematological counts and inflammatory markers show limited sensitivity and specificity for early detection.

Purpose of the Study:

• To address the diagnostic difficulties of early-onset sepsis in neonates.
• To evaluate the utility of laboratory tests in diagnosing neonatal sepsis.
• To determine the optimal combination of analytes for improved diagnostic accuracy.

Main Methods:

• Review of current diagnostic approaches for neonatal sepsis.
• Analysis of hematological counts, acute-phase reactants, and inflammatory cytokines.
• Assessment of combined biomarker strategies for sepsis diagnosis.

Main Results:

• Abnormal hematological counts and inflammatory markers are not consistently sensitive or specific for early sepsis onset.
• Combinations of laboratory measurements can enhance diagnostic test performance.
• Laboratory tests are most reliable for retrospectively excluding infection based on the absence of an acute-phase response.

Conclusions:

• Accurate and timely diagnosis of early-onset sepsis remains a critical unmet need in neonatology.
• Further research is needed to identify optimal biomarker combinations for early sepsis detection.
• Current laboratory tests have a defined role in the retrospective exclusion of neonatal sepsis.