The Role of sTREM-1 as a predictor of Septic Shock and Death in Neonatal sepsis

Introduction: Neonatal sepsis is the third leading cause of neonatal mortality, only behind rematurity 
and intrapartum related complication. Objectives: We aimed to determine the role of sTREM-1 as 
predictor of septic shock and death in septic neonates and to determine cut off value for prognosis of 
sepsis. Patients and methods: The study was conducted over the period from August 2016 to July 
2017 and included 60 neonates with neonatal sepsis who were collected from NICU at Minia 
Children & Maternity University Hospital and were grouped according to outcome into surviviors 
group and death group. All neonates were subjected to full history taking , clinical examination and 
laboratory investigations including CBC including differential white blood cell count and platelet 
count, CRP, Plasma sTREM-1 level quantified with sTREM-1 human ELISA kit and blood culture)
Results: Higher Percentage of death related to female sex and even within surviving group the 
percentage of males was higher than females The gestational age was statistical significantly lower in 
death group than in the survivor group. From clinical signs mean arterial blood pressure level was 
significantly lower in the death group than in survivors group but the heart rate and respiratory rate 
were highly significant in death group than in survivor group. TLC, neutrophil percentage and 
STREM-1 were statistical significantly higher in the death group than in survivors group. sTREM-1 
cut-off value of 448.2% pg/ml would exhibit a sensitivity of 86.67% and specificity of 95.56% PPV 
would be 86.7% and NPV 95.6% for prognosis of neonatal sepsis There was no statistical 
significance difference between the death and survivors group as regarding the organisms detected in 
both blood cultures. Conclusion: sTREM-1 has the potential to provide excellent predictive value. 
For outcome of neonatal sepsis Further trials with larger sample sizes are needed to identify the 
optimal cut-off value and to establish a diagnostic accuracy.