ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2020, 5(2): 29–35
Medicine. Reviews

Neonatal Sepsis: Modern Directions of Diagnostics

Kosenko K. O.

Neonatal sepsis is one of the most relevant and debatable problems of modern neonatology. Despite improved therapeutic strategies, sepsis remains the leading cause of morbidity and mortality in the neonatal period, especially among premature newborns, low-birth-weight newborns and extremely low birth weight newborns. Timely diagnosis of neonatal sepsis is a difficult task due to the lack of a specific clinical picture of the disease and insufficient diagnostic value of existing laboratory tests. Nowadays none of the laboratory markers is characterized by a high level of diagnostic significance in order to use it as the only criterion for the accurate diagnosis of sepsis in newborns. Therefore, this disease should be diagnosed comprehensively, only taking into account clinical data and the results of laboratory and instrumental methods. Expanding the neonatal sepsis complex integrated diagnostic panel will allow predicting the development of a systemic inflammatory response syndrome and multiple organ dysfunctions in the early stages of the disease, which, in the end, will help to choose the optimal tactics for effective antibiotic therapy. It is relevant to search for new modern tests that may be of clinical importance for the diagnosis, prognosis and effectiveness of therapy. The article provides a review of international studies on the effectiveness of the new marker of sepsis, namely triggering receptor, expressed on myeloid cells type-1 for early diagnosis and monitoring of neonatal sepsis, reflects information about the statistical value of the test in sensitivity, specificity, prognostic value of positive and negative results. There are modern data on the determination of the soluble form of triggering receptor expressed on myeloid cells type-1has high sensitivity and specificity for the differential diagnosis between neonatal sepsis and non-infectious critical conditions in newborns. An analysis of the literature data suggests that the definition of triggering receptor expressed on myeloid cells type-1 has early diagnostic and prognostic value, which allows it to be recommended for clinical usage in order to further improve the diagnosis of neonatal sepsis and, as a result, a decrease in the mortality rate and the development of long-term adverse prognoses from this disease. Conclusion. It is advisable to conduct further large-scale studies aimed at determining the reference values of the content of the soluble form of the receptor in the blood serum of newborns taking into account the gestational age and birth weight.

Keywords: neonatal sepsis, diagnostics, triggering receptor expressed on myeloid cells type-1, preterm infants

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