Feasibility of phagocytes functional testing in neonatal sepsis diagnostics

Abstract

Neonatal sepsis is a problem still relevant for healthcare in Russia and worldwide due to high mortality and resistance to treatment. Generalization of infection in newborns occurs because of innate immunity deficiency that particularly leads to neutrophil and monocyte malfunction. Nowadays clinical practice of neonatal sepsis diagnostics does not include phagocytes functional testing. Purpose. The study aims at evaluating the ability of sepsis biomarkers (CRP, PCT, lactate, CD64, CD16, HLA-DR) to differentiate the pathogenesis of organ dysfunction in newborns in the ICU setting.Material and methods. We assessed the surface expression of neutrophil CD64 and CD16, as well as monocytic HLA-DR in newborn ICU patients with different genesis of multiple organ failure — sepsis, asphyxia and combined; as well as different outcomes of hospitalization in the ICU — survivors and deaths.Results. We have shown a significant increase in the neutrophil CD64 expression and a decrease in the monocytic HLA-DR in infectious and combined genesis of multiple organ failure compared with severe asphyxia; deaths were associated with reduced expression of neutrophil CD16.Conclusion. Our data could substantiate combined use of the phagocytes functional testing indicators together with conventional sepsis biomarkers in order to increase their prognostic and predictive value.