Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in neonatal sepsis

Nurses' experiences in neonatal sepsis prevention and management: a qualitative cross-sectional study at selected hospitals in a metropolitan area

BACKGROUND

Neonatal sepsis represents a significant cause of morbidity and mortality among infants in healthcare settings. This study explored nurses' experiences in preventing and managing neonatal sepsis in the Tamale metropolis.

METHODS

An exploratory, descriptive qualitative cross-sectional study design was used, and data was collected using semi-structured interviews. The sample size was determined at the point of data saturation of fifteen participants. Thematic analysis was employed to identify codes, subthemes, and themes within the interview transcripts.

RESULTS

Three major challenges nurses face in preventing and managing neonatal sepsis, including (1) the absence of a protocol for handling newborns upon admission, (2) an excessive workload that made it difficult for staff to follow infection prevention protocols, and (3) inadequate, obsolete and/or lack of equipment that caused devices to be overused. The nurses also identified critical psychological and emotional difficulties they encounter as a result of working within such a stressful environment. Other activities nurses conducted were handwashing before and after every procedure, infection prevention, and separating the babies in the incubator. In managing babies with neonatal sepsis, nurses provided daily treatment, hygiene care, and supported activities of living. The nurses also assert that the availability of resources, appropriate staff, and critical skills are important for preventing and managing neonatal sepsis.

CONCLUSION

The lack of basic working consumables like gloves, syringes, and needles, inadequate staff, and lack of defined protocol of care were identified as critical challenges that hamper the care provided in neonatal care units. Hospital authorities must focus attention on addressing the critical challenges faced by neonatal care units. Also, measures should be instituted to address the emotional and psychological concerns associated with nursing care. Future research must consider the level of influence of each of the challenges enumerated on nurses' overall health.

Investigation of the Diagnostic Value of Cerebrospinal Fluid and Serum sTREM-1 Levels in Neonatal Meningitis

Background: The aim of this study is to investigate the diagnostic value of cerebrospinal fluid (CSF) and serum levels of the soluble form of triggering receptor-1 expressed on myeloid cells (sTREM-1) in neonatal meningitis. Methods: Serum sTREM-1 levels were measured in all neonatal sepsis patients at the start of antibiotic therapy and the 48th hour of treatment. At the beginning of antibiotic therapy, CSF samples were collected for sTREM-1 measurements. Control CSF samples were also collected from the patients with meningitis at the 48th hour of treatment. Results: A total of 77 preterm (50) and term (27) patients with neonatal sepsis were included in the study. There was no significant difference between the CSF sTREM-1 levels of patients with and without meningitis. The CSF sTREM-1 levels of preterm infants with meningitis decreased significantly after treatment (p = 0.038). Although the CSF/serum sTREM-1 ratios tended to increase in babies with meningitis, no significant difference was found between the groups. CSF/serum sTREM-1 ratios (mean ± SD) were 1.42 ± 0.91 and 1.14 ± 0.85 in preterm babies with and without meningitis and 1.15 ± 0.97 and 0.97 ± 0.55 in term babies with and without meningitis, respectively. Conclusions: Serum and CSF sTREM-1 levels increase in patients with neonatal sepsis. CSF s-TREM-1 levels decrease after treatment in preterm infants with meningitis.

Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction

The diagnosis of sepsis still lacks a practical and reliable gold standard. The purpose of this study was to confirm the effect of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) combined with soluble suppression of tumorigenicity 2 (sST2) in the diagnosis of sepsis through the correlation between sTREM-1, sST2, and sequential organ failure assessment (SOFA) scores. Baseline data of 91 patients with sepsis in the intensive care unit were collected, sTREM-1 and sST2 were detected, and the correlation between markers and SOFA score was analyzed. Besides, the prognostic value of baseline and postadmission indicators for sepsis was analyzed with death as the outcome. The results showed that the expressions of sST2 and sTREM-1 in death group and survival group were higher than those in the survival group (p < 0.05). Correlation analysis showed that sST2, sTREM-1, and the joint diagnosis model had a high correlation with SOFA score (p < 0.05), but poor correlation with Acute Physiology and Chronic Health Evaluation Ⅱ score (p > 0.05). Among them, joint diagnosis model has the highest correlation. Receiver operating characteristic curve analysis showed that combined diagnosis had higher area under curve values. sTREM-1/sST2 can be better used in the diagnosis of sepsis than the single biomarker detection, and the combination of the above two biomarkers has potential application value in the detection and prognosis prediction of sepsis.

Feasibility of phagocytes functional testing in neonatal sepsis diagnostics

Neonatal sepsis is a problem still relevant for healthcare in Russia and worldwide due to high mortality and resistance to treatment. Generalization of infection in newborns occurs because of innate immunity deficiency that particularly leads to neutrophil and monocyte malfunction. Nowadays clinical practice of neonatal sepsis diagnostics does not include phagocytes functional testing. Purpose. The study aims at evaluating the ability of sepsis biomarkers (CRP, PCT, lactate, CD64, CD16, HLA-DR) to differentiate the pathogenesis of organ dysfunction in newborns in the ICU setting.Material and methods. We assessed the surface expression of neutrophil CD64 and CD16, as well as monocytic HLA-DR in newborn ICU patients with different genesis of multiple organ failure — sepsis, asphyxia and combined; as well as different outcomes of hospitalization in the ICU — survivors and deaths.Results. We have shown a significant increase in the neutrophil CD64 expression and a decrease in the monocytic HLA-DR in infectious and combined genesis of multiple organ failure compared with severe asphyxia; deaths were associated with reduced expression of neutrophil CD16.Conclusion. Our data could substantiate combined use of the phagocytes functional testing indicators together with conventional sepsis biomarkers in order to increase their prognostic and predictive value.

Utility of P-SEP, sTREM-1 and suPAR as Novel Sepsis Biomarkers in SARS-CoV-2 Infection

The coronavirus disease 2019 is a highly contagious viral infection caused by SARS-CoV-2 virus, member of coronaviridae family. It causes life threatening complications due to complexity and rapid onset course of the disease. Early identification of high-risk patients who require close monitoring and aggressive treatment remains challengeable till date. Novel biomarkers which help to identify high risk patients at the early stage is high priority. Objective of this review to find utility of P-SEP, sTREM-1 and suPAR for diagnosis, risk stratification and prognosis of SARS-CoV-2 infected cases. Soluble receptors like, P-SEP, sTREM-1 and suPAR have been involved in immune regulation in SARS-CoV-2 infection and elevate more in severe cases. A comprehensive research of databases like PubMed, EMBASE, CNKI and Web of Science was performed for relevant studies. A total of nine out of fifteen research literature in initial screening were included for this review. Interestingly all studies have reported high levels of P-SEP, sTREM-1 and suPAR in SARS-CoV-2 infected cases and the biomarkers positively correlated with severity of infection. This implies that P-SEP, sTREM-1 and suPAR can be implemented as surrogate marker in blood profile for early diagnosis, risk stratification and prognosis in SARS-CoV-2 for better management in Indian population at the current situation.