Cord blood proteins help detect early sepsis in preterm infants

Scientists from Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago and colleagues identified several proteins from the umbilical cord blood of preterm newborns that signal acute systemic inflammation as an immune response to infection, providing objective and noninvasive means to diagnose early onset sepsis. This finding could spare infants from prolonged exposure to unnecessary antibiotics, which leaves them at risk for subsequent serious infections and dysregulation of the microbiome that can impact the immune system and metabolism. Results were published in JCI Insight.

Early onset sepsis occurs within 72 hours of life and is more common in preterm infants. It usually develops in utero, and intraamniotic infection is often the trigger for preterm birth. Early onset sepsis is hard to diagnose definitively from clinical signs, so antibiotics are started while waiting for culture results. Among very low birth weight infants nationally, 78 percent receive antibiotics after delivery. Around 25 percent of these babies are continued on antibiotics even when culture results are negative because they are presumed to have sepsis.

"Cord blood is an excellent source of information on the state of the baby's health at the time of delivery. Cord blood biomarker results can be available within 24 hours, allowing physicians to rule out early onset sepsis and discontinue antibiotics with more confidence," said lead author Leena B. Mithal, MD, pediatric infectious diseases specialist and Neal, Kathleen, and Adam Kulick Endowed Research Scholar at Lurie Children's, as well as Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "This could be an important advance in the care of premature infants."

Dr. Mithal and colleagues also developed a machine learning diagnostic algorithm based on cord blood biomarkers and risk factors for early onset sepsis. This innovation has a patent pending.

The next step will be to validate our findings through multicenter studies and clinical trials."

Dr. Leena B. Mithal, MD, pediatric infectious diseases specialist

Patrick Seed, MD, PhD, President & Chief Research Officer at Manne Research Institute, was a co-author on the study. He is the Children's Research Fund Chair in Basic Science and Professor of Pediatrics and Microbiology–Immunology at Northwestern University Feinberg School of Medicine.

Funding for this study came from the National Institutes of Health, Gerber Foundation, Friends of Prentice, Thrasher Research Fund, the Kulick Family and Stanley Manne Children's Research Institute at Lurie Children's.