SOLUBLE TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS -1 (sTREM-1) AS A DIAGNOSTIC AND PROGNOSTIC MARKER FOR LATE-ONSET SEPSIS IN PRETERM NEONATES.

Background: -The most challenging aspect in late-onset neonatal sepsis (LOS) is the difficulty of its early and accurate diagnosis. sTREM-1 is a novel and promising marker of sepsis. Objective: -Our aim was to investigate the role of serum levels of sTREM-1 in early diagnosis and prognosis of LOS. Subjects &Methods: -Fifty nine preterm neonates admitted to NICU of Mansoura University Children’s Hospital (MUCH), Egypt, were prospectively recruited in our study. Thirty infants with suspicion of LOS (sepsis group) and 29 gestational age and sex matched infants without sepsis served as a control group. All neonates were subjected to blood culture and routine sepsis screening. Levels of sTREM-1 were measured at enrollment and after 48-72 hours of antibiotic therapy in sepsis group. Results: - Initial sTREM-1 levels of the sepsis group were statistically significantly higher than those of the control group (584.8 pg/mL, {IQR: 116.7-709.8}; versus 76 pg/mL, {IQR: 31.9-591}, p .003). sTREM-1 value of 77.5 pg/mL was established as a cut-off value, with 90% sensitivity and 51.7% specificity for diagnosis of LOS. As for prognosis, sTREM-1 cuttoff value of 91.5 pg/ml for prediction of survival had 96.3% sensitivity and 100% specificity. Serum levels of sTREM-1 showed gradual decrease during treatment. Conclusion: - sTREM-1 can be used as a reliable biomarker for diagnosis, prognosis of LOS and for monitoring response to treatment in preterm infants