Multiparameter flow cytometry analysis of leukocyte markers for diagnosis in preterm neonatal sepsis

Purpose: Neonatal sepsis is an important public health concern worldwide due to its immediate lethality and long-term morbidity rates, Clinical evaluation and laboratory analyses are indispensable for diagnosis of neonatal sepsis. However, assessing multiple biomarkers in neonates is difficult due to limited blood availability. The aim is to investigate if the neonatal sepsis in preterm could be identified by multiparameter analysis with flow cytometry. Materials and Methods: The expression of activation-related molecules was evaluated by flow cytometry in newborn with or without risk factors for sepsis. Results: Our analysis revealed that several markers could be useful for sepsis diagnosis, such as CD45RA, CD45RO, or CD71 on T cells; HLA-DR on NKT or classic monocytes, and TREM-1 on non-classic monocytes or neutrophils. However, ROC analysis shows that the expression of CD45RO on T lymphocytes is the only useful biomarker for diagnosis of neonatal late-onset sepsis. Also, decision tree analyses showed that CD45RO plus CD27 could help differentiate the preterm septic neonates from those with risk factors. Conclusions: Our study shows a complementary and practical strategy for biomarker assessment in neonatal sepsis.

Automated summary

The study reveals that multiple markers, such as CD45RA, CD45RO, CD71, HLA-DR, and TREM-1, may be useful for diagnosing neonatal sepsis. However, only the expression of CD45RO on T lymphocytes is identified as a useful biomarker for diagnosing neonatal late-onset sepsis. Additionally, decision tree analyses suggest that CD45RO combined with CD27 could help differentiate preterm septic neonates from those with risk factors.