Assessment of the diagnostic significance of pentraxin-3 in conjunction with procalcitonin (PCT) and C-reactive protein (CRP) for neonatal sepsis

Abstract

Objective: This study aimed to compare serum levels of pentraxin-3 (PTX-3) in neonates with sepsis against those without sepsis and to assess the diagnostic value of PTX-3 in relation to conventional inflammatory markers. Methods: Between June and December 2020, a total of 109 neonates aged 1 to 21 days, with birth weights ranging from 1795 g to 4200 g, and who met the diagnostic criteria outlined in the “Expert Consensus on the Diagnosis and Treatment of Neonatal Sepsis” (2019) were examined in this prospective study, including 35 with sepsis, 36 with localized infections, and 38 without any infections. Neonates with congenital malformations, intrauterine viral infections, prior antibiotic treatment or without parental consent were excluded from the study. Blood samples were collected and analyzed for routine blood parameters, liver and kidney function metrics, levels of C-reactive protein (CRP), procalcitonin (PCT), lactic acid, and PTX-3. Results: The incidence of premature rupture of membranes was significantly lower in the sepsis and localized infection groups compared to the non-infected group (22.86%, 11.11%, and 2.63%; P < 0.05). White blood cell (WBC) counts were significantly elevated in both the sepsis and localized infection groups when compared to the non-infected group (P < 0.05). Notable differences were also found in lactate dehydrogenase (LDH) and calcium (Ca) levels (P < 0.05). Serum levels of CRP, PCT, and PTX-3 were significantly higher in the sepsis group (P < 0.05). Additionally, PTX-3 levels demonstrated a strong correlation with both CRP and PCT (P < 0.01). PTX-3, PCT, and platelet distribution width (PDW) emerged as independent risk factors for neonatal infection, while WBC, platelet count (PLT), CRP, PTX-3, PDW, and pH were identified as independent risk factors for sepsis (P < 0.05). The combination of PTX-3, CRP, PCT, and WBC exhibited the highest diagnostic efficiency for neonatal infection (AUC = 0.954, sensitivity 97.4%, specificity 83.1%; P < 0.01). For sepsis, the combined markers also demonstrated the best diagnostic performance (AUC = 0.855, sensitivity 83.3%, specificity 80.0%; P < 0.01). Conclusion: PTX-3 shows promise as a biomarker for neonatal sepsis, and when combined with WBC, CRP, and PCT, it significantly enhances both diagnostic sensitivity and specificity. Clinical trial number: Not applicable.