Can Endocan Predict Late-Onset Neonatal Sepsis?

Abstract

Objective Endocan, a proteoglycan secreted by endothelial cells, plays a role in the pathogenesis of sepsis. Endocan is an effective diagnostic and prognostic biomarker of sepsis in adult patients. We evaluate the utility of endocan as a new biomarker in the recognition of late-onset neonatal sepsis (LOS) in preterm infants.

Methods This study included preterm infants at gestational age ≤ 32 weeks diagnosed with LOS. Sepsis was diagnosed in the presence of three or more clinical findings plus significant elevation of C-reactive protein (CRP) or interleukin 6 (IL-6) levels. Blood samples were obtained to determine leukocyte count, CRP, IL-6, and endocan levels immediately after the sepsis diagnosis and on the 3rd and 7th day after diagnosis.

Results A total of 102 preterm infants, 52 with LOS (21 proven, 31 suspected sepsis) and 50 controls, were included in the study. Mean leukocyte count, serum CRP, IL-6, and endocan levels were significantly higher in the LOS group compared with healthy controls (p < 0.001) at enrolment. Serial measurements showed no significant difference in CRP and IL-6 levels between the proven and suspected sepsis groups, while endocan levels were significantly higher at enrolment and on day 7 in the proven sepsis group (p = 0.003 and p = 0.01, respectively). The endocan levels of preterm infants who died were significantly higher at all time points (p < 0.001, p = 0.001, and p = 0.004, respectively).

Conclusion Endocan is an effective, reliable, and promising new biomarker for detecting LOS in preterm infants.

Keywords

endocan - CRP - IL-6 - preterm infants - late-onset neonatal sepsis

Authors' Contributions

M. Buyuktiryaki, C. Tayman, M.Y. Oncel, and S.S. Oguz designed the research; M. Buyuktiryaki, N. Okur, U. Cakır, and H. Halil undertook data collection; U. Serkant performed the data analysis and interpretation; M. Buyuktiryaki, C. Tayman, and M.Y. Oncel performed the statistical analyses; M. Buyuktiryaki, N. Okur, U. Cakır, H. Halil, C. Tayman, and S.S. Oguz wrote the paper. M. Buyuktiryaki and C. Tayman had primary responsibility for the final content.

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