The Role and Validity of Diagnostic Biomarkers in Late-Onset Neonatal Sepsis

Sepsis remains a leading cause of mortality in the neonatal population, and currently, there is still no consensus on an accurate biomarker that can aid prompt diagnosis. This review focuses on studies investigating biomarkers for late-onset neonatal sepsis specifically. We discuss the current evidence for traditionally used biomarkers and present recent developments on more novel markers. Suitable articles were selected from PubMed, Embase, Medline, Cochrane Handbook of Systematic Reviews, and ScienceDirect. Inclusion criteria were studies published from 2010 to 2020. Exclusion criteria were animal model-based studies. Keywords in search strategy were late-onset neonatal sepsis + biomarkers + diagnosis. Evidence is growing increasingly weak for commonly studied biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). Levels of markers such as Serum Amyloid A and Neutrophil CD64 increase more rapidly post-onset of infection compared to CRP. Moreover, this review found that the more novel biomarkers discussed such as presepsin and endocan may show superior and more promising potential as diagnostic markers. However, larger studies over multicenters are deemed essential to ascertain the ideal biomarker.