Hepcidin as a biomarker of neonatal infections

Abstract

Introduction/Objective. Nonspecific clinical signs of neonatal infection dictate routinely determination of C-reactive protein (CRP) and procalcitonin levels in order to confirm the diagnosis. As hepcidin is an acute phase reactant, the aim of our study was to analyze its significance in diagnosis of neonatal infections. Methods. The prospective study included 71 term neonates, 37 with signs of infection in the absence of other pathological conditions and 34 healthy neonates. After standard bacteriological examination, at the time of diagnosis and after six days of antibiotic therapy, complete blood count, serum CRP, procalcitonin, and hepcidin were determined. Results. There was no difference in serum hepcidin levels between the control (55.17 ? 21.22 ng/ml) and the infection group (59.72 ? 59.7 ng/ml) on the first day. Hepcidin values in neonates with infection up to 72 hours were significantly lower (30.2 ng/ml, IQ: 25.9?39.9 ng/ml) than in older neonates (82.2 ng/ml, IQ: 39.7?128.1 ng/ml). In neonates up to 72 hours, after six days of antibiotics, the hepcidin values show a significant increase (36.68 ng/ml, IQ; 31.23?50.3 ng/ml). High hepcidin values (128.05 ng/ml, IQ: 60.95?201 ng/ml) were recorded in neonates with CRP over 100 mg/l. Conclusion. Our results shows that the determination of serum hepcidin as a marker of neonatal infection is not relevant in neonates up to 72 hours of life. After six days of antibiotic therapy, the neonates of this group reacted with an increase in hepcidin, while the parallel determined values of CRP and procalcitonin showed a significant decrease.