Meta-Analysis of Diagnostic Markers of Neonatal Sepsis

Abstract

Background: Neonatal sepsis is the single most important cause of neonatal deaths in the community. It remains a major cause of mortality in newborn and life –threatening disorder in infants Aim of the study: to assess the validity of using diagnostic markers in predicting sepsis. Methodology: This was a systemic review of Meta-analysis. More than 200 potentially relevant studies were collected in 2 years standing from 2012 to 2014 but only 42 met our inclusion criteria. A standard method for meta-analysis of diagnostic markers evaluation was performed using Biostat, Comprehensive Meta-analysis version 3.0 Findings: Meta-analysis was performed on 2722 neonates divided into 2 groups according to clinical manifestations of neonatal sepsis and laboratory findings. PROM was the commonest risk factor predisposing to sepsis. Klebsiella and staphylococcus aureus were the most common isolated organism. Based on results from the studies included in this review, 6predominant markers used to evaluate early diagnosis of neonatal sepsis, PCT, IL-6, TNF-α, CD64, sICAM and Eselectin. Procalcitonin was highly significantly elevated with sensitivity 0.93 whereas specificity was 0.87 and it had the most diagnostic accuracy 0.95. sICAM was the most sensitive marker0.95 its diagnostic accuracy and specificity were 0.93 and 0.90, TNF-α had diagnostic accuracy (0.92) sensitivity and specificity were 0.86, the sensitivity of Eselectin was 0.92, its diagnostic accuracy and specificity were 0.91 and 0.82. IL6 had diagnostic accuracy 0.93; the specificity and sensitivity were 0.90 and 0.88. CD64 was the most specific biomarker for predicting neonatal sepsis 0.91, sensitivity0.87, and accuracy0.92. Conclusion: Based on results from the studies included in this review, it was clear that serum sICAM had a high sensitivity for diagnosis of neonatal sepsis; CD64 had a high specificity and serum procalcitonin had the most diagnostic accuracy. Key words: Neonatal sepsis, Noanatal markers, Meta-analysis, procalcitonin, sICAM