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Review

Biomarkers for neonatal sepsis: recent developments

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Pages 157-168 | Published online: 17 Sep 2014

References

  • Stoll BJ, Hansen N, Fanaroff AA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2 Pt 1):285–291.
  • Tsai MH, Chu SM, Lee CW, et al. Recurrent late-onset sepsis in the neonatal intensive care unit: incidence, clinical characteristics and risk factors. Clin Microbiol Infect. 2014.
  • Polin RA. Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012;129(5):1006–1015.
  • Centers for Disease Control and Prevention (CDC). Group B Strep Infection in Newborns [webpage on the Internet]. Available at: http://www.cdc.gov/groupbstrep/about/newborns-pregnant.html. Last updated November 18, 2010.
  • Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2014;6:CD007467.
  • Garcia-Prats JA, Cooper TR, Schneider VF, Stager CE, Hansen TN. Rapid detection of microorganisms in blood cultures of newborn infants utilizing an automated blood culture system. Pediatrics. 2000;105(3 Pt 1):523–527.
  • Stoll BJ, Hansen NI, Adams-Chapman I, et al. National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004;292(19):2357–2365.
  • Ganatra HA, Stoll BJ, Zaidi AK. International perspective on early-onset neonatal sepsis. Clin Perinatol. 2010;37(2):501–523.
  • Pappas A, Kendrick DE, Shankaran S, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Chorioamnionitis and early childhood outcomes among extremely low-gestational-age neonates. JAMA Pediatr. 2014;168(2):137–147.
  • Stoll BJ, Hansen NI, Bell EF, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010;126(3):443–456.
  • Ng PC. Diagnostic markers of infection in neonates. Arch Dis Child Fetal Neonatal Ed. 2004;89(3):F229–F235.
  • Mehr S, Doyle LW. Cytokines as markers of bacterial sepsis in newborn infants: a review. Pediatr Infect Dis J. 2000;19(9):879–887.
  • Commins SP, Borish L, Steinke JW. Immunologic messenger molecules: cytokines, interferons, and chemokines. J Allergy Clin Immunol. 2010; 125(2 Suppl 2):S53–S72.
  • D’Alquen D, Kramer BW, Seidenspinner S, et al. Activation of umbilical cord endothelial cells and fetal inflammatory response in preterm infants with chorioamnionitis and funisitis. Pediatr Res. 2005;57(2):263–269.
  • Ng PC, Lam HS. Diagnostic markers for neonatal sepsis. Curr Opin Pediatr. 2006;18(2):125–131.
  • Lever A, Mackenzie I. Sepsis: definition, epidemiology, and diagnosis. BMJ. 2007;335(7625):879–883.
  • Buttery JP. Blood cultures in newborns and children: optimising an everyday test. Arch Dis Child Fetal Neonatal Ed. 2002;87(1):F25–F28.
  • Christensen RD, Baer VL, Gordon PV, et al. Reference ranges for lymphocyte counts of neonates: associations between abnormal counts and outcomes. Pediatrics. 2012;129(5):e1165–e1172.
  • Chiesa C, Natale F, Pascone R, et al. C reactive protein and procalcitonin: reference intervals for preterm and term newborns during the early neonatal period. Clin Chim Acta. 2011;412(11–12):1053–1059.
  • Ng PC, Lam HS. Biomarkers for late-onset neonatal sepsis: cytokines and beyond. Clin Perinatol. 2010;37(3):599–610.
  • Lam HS, Ng PC. Biochemical markers of neonatal sepsis. Pathology. 2008;40(2):141–148.
  • van Dissel JT, van Langevelde P, Westendorp RG, Kwappenberg K, Frölich M. Anti-inflammatory cytokine profile and mortality in febrile patients. Lancet. 1998;351(9107):950–953.
  • Newman TB, Puopolo KM, Wi S, Draper D, Escobar GJ. Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics. 2010;126(5):903–909.
  • Griffin MP, Lake DE, Bissonette EA, Harrell FE, O’Shea TM, Moorman JR. Heart rate characteristics: novel physiomarkers to predict neonatal infection and death. Pediatrics. 2005;116(5):1070–1074.
  • Philip AG, Hewitt JR. Early diagnosis of neonatal sepsis. Pediatrics. 1980;65(5):1036–1041.
  • Makkar M, Gupta C, Pathak R, Garg S, Mahajan NC. Performance evaluation of hematologic scoring system in early diagnosis of neonatal sepsis. J Clin Neonatol. 2013;2(1):25–29.
  • Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr. 1988;112(5):761–767.
  • Polin RA, Randis TM. Biomarkers for late-onset neonatal sepsis. Genome Med. 2010;2(9):58.
  • Khair KB, Rahman MA, Sultana T, Roy CK, Rahman MQ, Ahmed AN. Early diagnosis of neonatal septicemia by hematologic scoring system, C-reactive protein and serum haptoglobin. Mymensingh Med J. 2012;21(1):85–92.
  • Khair KB, Rahman MA, Sultana T, Roy CK, Rahman MQ, Ahmed AN. Early diagnosis of neonatal septicemia by hematologic scoring system, C-reactive protein and serum haptoglobin. Mymensingh Med J. 2012;21(1):85–92.
  • Wynn JL, Neu J, Moldawer LL, Levy O. Potential of immunomodulatory agents for prevention and treatment of neonatal sepsis. J Perinatol. 2009;29(2):79–88.
  • Levy O. Innate immunity of the newborn: basic mechanisms and clinical correlates. Nat Rev Immunol. 2007;7(5):379–390.
  • Adkins B, Leclerc C, Marshall-Clarke S. Neonatal adaptive immunity comes of age. Nat Rev Immunol. 2004;4(7):553–564.
  • Kollmann TR, Crabtree J, Rein-Weston A, et al. Neonatal innate TLR-mediated responses are distinct from those of adults. J Immunol. 2009;183(11):7150–7160.
  • Rittirsch D, Flierl MA, Ward PA. Harmful molecular mechanisms in sepsis. Nat Rev Immunol. 2008;8(10):776–787.
  • Hotchkiss RS, Karl IE. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348(2):138–150.
  • Abraham E, Singer M. Mechanisms of sepsis-induced organ dysfunction. Crit Care Med. 2007;35(10):2408–2416.
  • Cinel I, Dellinger RP. Advances in pathogenesis and management of sepsis. Curr Opin Infect Dis. 2007;20(4):345–352.
  • Jean-Baptiste E. Cellular mechanisms in sepsis. J Intensive Care Med. 2007;22(2):63–72.
  • Sriskandan S, Altmann DM. The immunology of sepsis. J Pathol. 2008;214(2):211–223.
  • Ng PC, Cheng SH, Chui KM, et al. Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 1997;77(3):F221–F227.
  • Ng PC, Li K, Leung TF, et al. Early prediction of sepsis-induced disseminated intravascular coagulation with interleukin-10, interleukin-6, and RANTES in preterm infants. Clin Chem. 2006;52(6):1181–1189.
  • Ng PC, Li K, Chui KM, et al. IP-10 is an early diagnostic marker for identification of late-onset bacterial infection in preterm infants. Pediatr Res. 2007;61(1):93–98.
  • Turunen R, Andersson S, Nupponen I, Kautiainen H, Siitonen S, Repo H. Increased CD11b-density on circulating phagocytes as an early sign of late-onset sepsis in extremely low-birth-weight infants. Pediatr Res. 2005;57(2):270–275.
  • Ng PC, Li K, Wong RP, Chui KM, Wong E, Fok TF. Neutrophil CD64 expression: a sensitive diagnostic marker for late-onset nosocomial infection in very low birthweight infants. Pediatr Res. 2002;51(3):296–303.
  • Speer C, Bruns A, Gahr M. Sequential determination of CRP, alpha 1- antitrypsin and haptoglobin in neonatal septicaemia. Acta Paediatr Scand. 1983;72(5):679–683.
  • Seibert K, Yu VY, Doery JC, Embury D. The value of C-reactive protein measurement in the diagnosis of neonatal infection. J Paediatr Child Health. 1990;26(5):267–270.
  • Berger C, Uehlinger J, Ghelfi D, Blau N, Fanconi S. Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia. Eur J Pediatr. 1995;154(2):138–144.
  • Da Silva O, Ohlsson A, Kenyon C. Accuracy of leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis: a critical review. Pediatr Infect Dis J. 1995;14(5):362–366.
  • Bilavsky E, Yarden-Bilavsky H, Ashkenazi S, Amir J. C-reactive protein as a marker of serious bacterial infections in hospitalized febrile infants. Acta Paediatr. 2009;98(11):1776–1780.
  • Cetinkaya M, Ozkan H, Köksal N, Celebi S, Hacimustafaoglu M. Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants. J Perinatol. 2009;29(3):225–231.
  • Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks. Neonatology. 2012;102(1):25–36.
  • Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med. 1999;17(6):1019–1025.
  • Pourcyrous M, Bada HS, Korones SB, Baselski V, Wong SP. Significance of serial C-reactive protein responses in neonatal infection and other disorders. Pediatrics. 1993;92(3):431–435.
  • Kawamura M, Nishida H. The usefulness of serial C-reactive protein measurement in managing neonatal infection. Acta Paediatr. 1995;84(1):10–13.
  • Franz AR, Steinbach G, Kron M, Pohlandt F. Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as markers of bacterial infections. Pediatrics. 1999;104(3 Pt 1):447–453.
  • Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis. 2007;7(3):210–217.
  • Luzzani A, Polati E, Dorizzi R, Rungatscher A, Pavan R, Merlini A. Comparison of procalcitonin and C-reactive protein as markers of sepsis. Critical Care Medicine. 2003;31(6):1737–1741.
  • Chiesa C, Panero A, Rossi N, et al. Reliability of procalcitonin concentrations for the diagnosis of sepsis in critically ill neonates. Clin Infect Dis. 1998;26(3):664–672.
  • Whicher J, Bienvenu J, Monneret G. Procalcitonin as an acute phase marker. Ann Clin Biochem. 2001;38(Pt 5):483–493.
  • Pavcnik-Arnol M, Hojker S, Derganc M. Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein. Intensive Care Med. 2004;30(7):1454–1460.
  • van Rossum AMC, Wulkan RW, Oudesluys-Murphy AM. Procalcitonin as an early marker of infection in neonates and children. Lancet Infect Dis. 2004;4(10):620–630.
  • Resch B, Gusenleitner W, Müller W. Procalcitonin, interleukin-6, C-reactive protein and leukocyte counts in infants with bronchiolitis. Pediatr Infect Dis J. 2003;22(5):475–476.
  • Enguix A, Rey C, Concha A, Medina A, Coto D, Diéguez MA. Comparison of procalcitonin with C-reactive protein and serum amyloid for the early diagnosis of bacterial sepsis in critically ill neonates and children. Intensive Care Med. 2001;27(1):211–215.
  • Simon L, Saint-Louis P, Amre DK, Lacroix J, Gauvin F. Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome. Pediatr Crit Care Med. 2008;9(4):407–413.
  • Kordek A, Hałasa M, Podraza W. Early detection of an early onset infection in the neonate based on measurements of procalcitonin and C-reactive protein concentrations in cord blood. Clin Chem Lab Med. 2008;46(8):1143–1148.
  • Yuan H, Huang J, Lv B, et al. Diagnosis value of the serum amyloid A test in neonatal sepsis: a meta-analysis. Biomed Res Int. 2013;2013:520294.
  • He R, Sang H, Ye RD. Serum amyloid A induces IL-8 secretion through a G protein-coupled receptor, FPRL1/LXA4R. Blood. 2003;101(4):1572–1581.
  • Lannergård A, Friman G, Ewald U, Lind L, Larsson A. Serum amyloid A (SAA) protein and high-sensitivity C-reactive protein (hsCRP) in healthy newborn infants and healthy young through elderly adults. Acta Paediatr. 2005;94(9):1198–1202.
  • Yamada T, Miyake N, Itoh K, Igari J. Further characterization of serum amyloid A4 as a minor acute phase reactant and a possible nutritional marker. Clin Chem Lab Med. 2001;39(1):7–10.
  • Ng PC, Ang IL, Chiu RW, et al. Host-response biomarkers for diagnosis of late-onset septicemia and necrotizing enterocolitis in preterm infants. J Clin Invest. 2010;120(8):2989–3000.
  • Arnon S, Litmanovitz I, Regev RH, Bauer S, Shainkin-Kestenbaum R, Dolfin T. Serum amyloid A: an early and accurate marker of neonatal early-onset sepsis. J Perinatol. 2007;27(5):297–302.
  • Arnon S, Litmanovitz I, Regev R, Lis M, Shainkin-Kestenbaum R, Dolfin T. The prognostic virtue of inflammatory markers during late-onset sepsis in preterm infants. J Perinat Med. 2004;32(2):176–180.
  • Delsesto D, Opal SM. Future perspectives on regulating pro-and anti-inflammatory responses in sepsis. Contrib Microbiol. 2011;17:137–156.
  • Behrendt D, Dembinski J, Heep A, Bartmann P. Lipopolysaccharide binding protein in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2004;89(6):F551–F554.
  • Turner D, Hammerman C, Rudensky B, Schlesinger Y, Goia C, Schimmel MS. Procalcitonin in preterm infants during the first few days of life: introducing an age related nomogram. Arch Dis Child Fetal Neonatal Ed. 2006;91(4):F283–F286.
  • Gerdes JS, Polin RA. Sepsis screen in neonates with evaluation of plasma fibronectin. Pediatr Infect Dis J. 1987;6(5):443–446.
  • Jurges ES, Henderson DC. Inflammatory and immunological markers in preterm infants: correlation with disease. Clin Exp Immunol. 1996;105(3):551–555.
  • Scott PH. Plasma lactoferrin levels in newborn preterm infants: effect of infection. Ann Clin Biochem. 1989;26(Pt 5):412–415.
  • Nupponen I, Andersson S, Järvenpää AL, Kautiainen H, Repo H. Neutrophil CD11b expression and circulating interleukin-8 as diagnostic markers for early-onset neonatal sepsis. Pediatrics. 2001;108(1):E12.
  • Weirich E, Rabin RL, Maldonado Y, et al. Neutrophil CD11b expression as a diagnostic marker for early-onset neonatal infection. J Pediatr. 1998;132(3 Pt 1):445–451.
  • Brown GD. Dectin-1: a signalling non-TLR pattern-recognition receptor. Nat Rev Immunol. 2006;6(1):33–43.
  • Kawai T, Akira S. The roles of TLRs, RLRs and NLRs in pathogen recognition. Int Immunol. 2009;21(4):317–337.
  • Wu YD, Chen LH, Wu XJ, et al. Gram stain-specific-probe-based real-time PCR for diagnosis and discrimination of bacterial neonatal sepsis. J Clin Microbiol. 2008;46(8):2613–2619.
  • Petrakou E, Mouchtouri A, Levi E, Lipsou N, Xanthou M, Fotopoulos S. Interleukin-8 and monocyte chemotactic protein-1 mRNA expression in perinatally infected and asphyxiated preterm neonates. Neonatology. 2007;91(2):107–113.
  • Lawn JE, Cousens S, Zupan J; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365(9462):891–900.
  • Martinot A, Leclerc F, Cremer R, Leteurtre S, Fourier C, Hue V. Sepsis in neonates and children: definitions, epidemiology, and outcome. Pediatr Emerg Care. 1997;13(4):277–281.
  • Lehrnbecher T, Schrod L, Kraus D, Roos T, Martius J, von Stockhausen HB. Interleukin-6 and soluble interleukin-6 receptor in cord blood in the diagnosis of early onset sepsis in neonates. Acta Paediatr. 1995;84(7):806–808.
  • Procianoy RS, Silveira RC. The role of sample collection timing on interleukin-6 levels in early-onset neonatal sepsis. J Pediatr (Rio J). 2004;80(5):407–410.
  • Resch B, Gusenleitner W, Müller WD. Procalcitonin and interleukin-6 in the diagnosis of early-onset sepsis of the neonate. Acta Paediatr. 2003;92(2):243–245.
  • Chiesa C, Pellegrini G, Panero A, et al. C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: influence of illness severity, risk status, antenatal and perinatal complications, and infection. Clin Chem. 2003;49(1):60–68.
  • Silveira RC, Procianoy RS. Evaluation of interleukin-6, tumour necrosis factor-alpha and interleukin-1beta for early diagnosis of neonatal sepsis. Acta Paediatr. 1999;88(6):647–650.
  • Hodge G, Hodge S, Han P, Haslam R. Multiple leucocyte activation markers to detect neonatal infection. Clin Exp Immunol. 2004;135(1):125–129.
  • Kishimoto T. The biology of interleukin-6. Blood. 1989;74(1):1–10.
  • Küster H, Weiss M, Willeitner AE, et al. Interleukin-1 receptor antagonist and interleukin-6 for early diagnosis of neonatal sepsis 2 days before clinical manifestation. Lancet. 1998;352(9136):1271–1277.
  • Raynor LL, Saucerman JJ, Akinola MO, Lake DE, Moorman JR, Fairchild KD. Cytokine screening identifies NICU patients with Gram-negative bacteremia. Pediatr Res. 2012;71(3):261–266.
  • Franz AR, Sieber S, Pohlandt F, Kron M, Steinbach G. Whole blood interleukin 8 and plasma interleukin 8 levels in newborn infants with suspected bacterial infection. Acta Paediatr. 2004;93(5):648–653.
  • Reinsberg J, Dembinski J, Dorn C, Behrendt D, Bartmann P, van Der Ven H. Determination of total interleukin-8 in whole blood after cell lysis. Clin Chem. 2000;46(9):1387–1394.
  • Orlikowsky TW, Neunhoeffer F, Goelz R, et al. Evaluation of IL-8-concentrations in plasma and lysed EDTA-blood in healthy neonates and those with suspected early onset bacterial infection. Pediatr Res. 2004;56(5):804–809.
  • Fotopoulos S, Mouchtouri A, Xanthou G, Lipsou N, Petrakou E, Xanthou M. Inflammatory chemokine expression in the peripheral blood of neonates with perinatal asphyxia and perinatal or nosocomial infections. Acta Paediatr. 2005;94(6):800–806.
  • Schultz C, Strunk T, Temming P, Matzke N, Härtel C. Reduced IL-10 production and -receptor expression in neonatal T lymphocytes. Acta Paediatr. 2007;96(8):1122–1125.
  • Ng PC, Li K, Wong RP, et al. Proinflammatory and anti-inflammatory cytokine responses in preterm infants with systemic infections. Arch Dis Child Fetal Neonatal Ed. 2003;88(3):F209–F213.
  • Schultz C, Temming P, Bucsky P, Göpel W, Strunk T, Härtel C. Immature anti-inflammatory response in neonates. Clin Exp Immunol. 2004;135(1):130–136.
  • Ng PC, Li G, Chui KM, et al. Neutrophil CD64 is a sensitive diagnostic marker for early-onset neonatal infection. Pediatr Res. 2004;56(5):796–803.
  • Bhandari V, Wang C, Rinder C, Rinder H. Hematologic profile of sepsis in neonates: neutrophil CD64 as a diagnostic marker. Pediatrics. 2008;121(1):129–134.
  • Wang K, Bhandari V, Chepustanova S, et al. Which biomarkers reveal neonatal sepsis? PLoS One. 2013;8(12):e82700.
  • Shozushima T, Takahashi G, Matsumoto N, Kojika M, Okamura Y, Endo S. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother. 2011;17(6):764–769.
  • Graversen JH, Madsen M, Moestrup SK. CD163: a signal receptor scavenging haptoglobin-hemoglobin complexes from plasma. Int J Biochem Cell Biol. 2002;34(4):309–314.
  • Fabriek BO, Dijkstra CD, van den Berg TK. The macrophage scavenger receptor CD163. Immunobiology. 2005;210(2–4):153–160.
  • Prashant A, Vishwanath P, Kulkarni P, et al. Comparative assessment of cytokines and other inflammatory markers for the early diagnosis of neonatal sepsis-a case control study. PLoS One. 2013;8(7):e68426.
  • Sprong T, Peri G, Neeleman C, et al. Pentraxin 3 and C-reactive protein in severe meningococcal disease. Shock. 2009;31(1):28–32.
  • Fiedler U, Reiss Y, Scharpfenecker M, et al. Angiopoietin-2 sensitizes endothelial cells to TNF-alpha and has a crucial role in the induction of inflammation. Nat Med. 2006;12(2):235–239.
  • Mankhambo LA, Banda DL, Jeffers G, et al; IPD Study Group. The role of angiogenic factors in predicting clinical outcome in severe bacterial infection in Malawian children. Crit Care. 2010;14(3):R91.
  • Eugen-Olsen J. suPAR – a future risk marker in bacteremia. J Intern Med. 2011;270(1):29–31.
  • Siahanidou T, Margeli A, Tsirogianni C, et al. Clinical value of plasma soluble urokinase-type plasminogen activator receptor levels in term neonates with infection or sepsis: a prospective study. Mediators Inflamm. 2014;2014:375702.
  • Wu Y, Wang F, Fan X, et al. Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis. Crit Care. 2012;16(6):R229.
  • Adly AA, Ismail EA, Andrawes NG, El-Saadany MA. Circulating soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as diagnostic and prognostic marker in neonatal sepsis. Cytokine. 2014;65(2):184–191.
  • Romano-Keeler J, Wynn JL, Maron JL. Great expectorations: the potential of salivary ‘omic’ approaches in neonatal intensive care. J Perinatol. 2014;34(3):169–173.
  • Castagnola M, Inzitari R, Fanali C, et al. The surprising composition of the salivary proteome of preterm human newborn. Mol Cell Proteomics. 2011;10(1):M110.003467.
  • Hendricks-Muñoz KD, Perez-Perez G, Xu J, Kim Y, Louie M. Maternal antenatal treatments influence initial oral microbial acquisition in preterm infants. Am J Perinatol. 2013;30(1):47–52.
  • Benitz WE. Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis. Clin Perinatol. 2010;37(2):421–438.
  • Suguna Narasimhulu S, Hendricks-Muñoz KD, Borkowsky W, Mally P. Usefulness of urinary immune biomarkers in the evaluation of neonatal sepsis: a pilot project. Clin Pediatr (Phila). 2013;52(6):520–526.
  • Fanos V, Van den Anker J, Noto A, Mussap M, Atzori L. Metabolomics in neonatology: fact or fiction? Semin Fetal Neonatal Med. 2013;18(1):3–12.
  • Dessì A, Corsello G, Stronati M, et al. New diagnostic possibilities in systemic neonatal infections: metabolomics. Early Hum Dev. 2014; 90 Suppl 1:S19–S21.
  • Fanos V, Caboni P, Corsello G, et al. Urinary (1)H-NMR and GC-MS metabolomics predicts early and late onset neonatal sepsis. Early Hum Dev. 2014;90 Suppl 1:S78–S83.
  • Buhimschi IA, Buhimschi CS. The role of proteomics in the diagnosis of chorioamnionitis and early-onset neonatal sepsis. Clin Perinatol. 2010;37(2):355–374.