Abstract

A clinical phenomenon known as neonatal sepsis is characterized by infection-related signs and symptoms in the first month of life, either with or without bacteremia. The main objective of the present study was to study the role of Toll-like receptors as a diagnostic marker for neonatal bacterial sepsis and its possibilities for differentiation between viral and bacterial neonatal infections. To gather information from patients, a cross-sectional study design was used. Study sample included 50 neonates who were categorized as a low-risk group and a high risk-group for sepsis. Both blood cultures and toll like receptors were investigated. Results showed that 18% of blood culture were positive, and the most prevalent bacterium was Group B Streptococcus. Comparing high-risk group with low-risk group for toll like receptors, CRP, and WBC showed that TLRs, CRP were higher in high-risk group compared with low-risk group (p < 0.05), except the levels of WBC that did not show significant variations (p = 0.072). Together, the study's findings showed how crucial it is to use toll-like receptors for diagnostic purposes.

Keywords: Neonatal Sepsis; Blood Culture; Group B Streptococcus; Toll Like Receptor; Diagnostic Marker

References

1. Tewabe T., et al. “Clinical outcome and risk factors of neonatal sepsis among neonates in Felege Hiwot referral Hospital, Bahir Dar, Amhara Regional State, North West Ethiopia 2016: a retrospective chart review”. BMC Research Notes1 (2017): 265.
2. Shirin M., et al. “Association of Admission Temperature and Outcome among Neonates with Sepsis in a Tertiary Care Hospital”. Dhaka Shishu (Children) Hospital Journal2 (2020).
3. Vijay K. “Toll-like receptors in immunity and inflammatory diseases: Past, present, and future”. International Immunopharmacology (2018): 59.
4. Bhandari V., et al. “Hematologic profile of sepsis in neonates: Neutrophil CD64 as a diagnostic marker”. Pediatric1 (2008).
5. Browne EP. “The role of toll-like receptors in retroviral infection”. Microorganisms11 (2020).
6. Denstaedt SJ., et al. “Sepsis and nosocomial infection: Patient characteristics, mechanisms, and modulation”. Frontiers in Immunology10 (2018).
7. Burstein R., et al. “Mapping 123 million neonatal, infant and child deaths between 2000 and 2017”. Nature7778 (2019).
8. Maglione PJ., et al. “Toll-like receptor signaling in primary immune deficiencies”. Annals of the New York Academy of Sciences1 (2015).
9. Akalu TY., et al. “Predictors of neonatal sepsis in public referral hospitals, Northwest Ethiopia: A case control study”. PLoS ONE6 (2020).
10. Paolucci M., et al. “How Can the Microbiologist Help in Diagnosing Neonatal Sepsis?” International Journal of Pediatrics (2012).
11. Ng S., et al. “Precision Medicine for Neonatal Sepsis”. Frontiers in Molecular Biosciences (2018): 5.
12. Wynn JL. “Defining neonatal sepsis”. Current Opinion in Pediatrics2 (2016): 135-140.
13. Schüller SS., et al. “Immunomodulation to prevent or treat neonatal sepsis: Past, present, and future”. In Frontiers in Pediatrics (2018): 6.
14. Li D and Wu M. “Pattern recognition receptors in health and diseases”. In Signal Transduction and Targeted Therapy1 (2021).
15. Płóciennikowska A., et al. “Co-operation of TLR4 and raft proteins in LPS-induced pro-inflammatory signaling”. Cellular and Molecular Life Sciences3 (2015): 557-581.
16. Koymans KJ., et al. “The TLR2 Antagonist Staphylococcal Superantigen-Like Protein 3 Acts as a Virulence Factor to Promote Bacterial Pathogenicity in vivo”. Journal of Innate Immunity6 (2017).
17. Chantratita N., et al. “TLR4 genetic variation is associated with inflammatory responses in Gram-positive sepsis”. Clinical Microbiology and Infection1 (2017).
18. Too LK., et al. “Double deficiency of toll-like receptors 2 and 4 alters long-term neurological sequelae in mice cured of pneumococcal meningitis”. Scientific Reports1 (2019).
19. Pandey S., et al. “Microbial sensing by toll-like receptors and intracellular nucleic acid sensors”. Cold Spring Harbor Perspectives in Biology1 (2015).
20. Vaure C and Liu Y. “A comparative review of toll-like receptor 4 expression and functionality in different animal species”. Frontiers in Immunology 5 (2014).
21. Satar M and Özlü, F. “Neonatal sepsis: A continuing disease burden”. In Turkish Journal of Pediatrics5 (2012).
22. Shrestha RK., et al. “Bacteriological study of neonatal sepsis and antibiotic susceptibility pattern of isolates in Kathmandu, Nepal”. Nepal Medical College Journal1 (2013).
23. Yadav NS., et al. “Bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of isolates admitted at Kanti Children’s Hospital, Kathmandu, Nepal”. BMC Research Notes1 (2018).
24. Eschborn S and Weitkamp JH. “Procalcitonin versus C-reactive protein: review of kinetics and performance for diagnosis of neonatal sepsis”. Journal of Perinatology7 (2019).
25. Trotman H. “The neonatal intensive care unit at the University Hospital of the West Indies: The first few years’ experience”. West Indian Medical Journal2 (2006).
26. Adatara P., et al. “Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana”. BioMed Research International (2018).