Neonatal leucocyte cell population data: reference intervals and relevance for detecting sepsis and necrotizing...

Area of Science:

• Neonatal immunology
• Clinical diagnostics
• Biomarker discovery

Background:

• Timely diagnosis of neonatal sepsis is critical but challenging.
• Cell Population Data (CPD) offer high-resolution leukocyte phenotyping for potential sepsis detection.
• This study aimed to establish neonatal CPD reference intervals and assess their utility for detecting sepsis and necrotizing enterocolitis (NEC).

Purpose of the Study:

• Establish reference intervals for neonatal leukocyte Cell Population Data (CPD).
• Evaluate the diagnostic performance of CPD, particularly NE-SFL, for neonatal sepsis and NEC.
• Compare CPD accuracy against traditional biomarkers like CBC and CRP.

Main Methods:

• Analyzed CPD from neutrophils, monocytes, and lymphocytes in hospitalized newborns.
• Derived reference intervals (5-95th percentiles) from a healthy reference group.
• Assessed CPD performance in detecting sepsis/NEC against CBC and CRP.

Main Results:

• Established reference intervals for neonatal CPD, showing distinct trajectories and decreasing distribution width with age.
• CPD in sepsis/NEC cases differed significantly from the reference group, especially neutrophil fluorescence intensity (NE-SFL).
• NE-SFL demonstrated superior accuracy (90% sensitivity, 76% specificity) compared to other CPD, CBC, and CRP.

Conclusions:

• Established neonatal CPD reference intervals, aiding interpretation of these preclinical parameters.
• Identified NE-SFL as a potential sepsis biomarker with superior diagnostic accuracy.
• CPD, particularly NE-SFL, offer a cost-effective, real-time tool for improving neonatal sepsis detection.