Pro-adrenomedullin as a Marker for Diagnosis of Neonatal Sepsis

Background: Neonatal sepsis (NS) is still one of the main causes of morbidity and death in various neonatal intensive care units (NICUs). The symptoms are variable and non-specific. Although timely and precise detection of NS is essential and increases survivability, it is still challenging for clinicians. Biomarkers can aid in early detection of NS. Adrenomedullin (ADM) is a peptide hormone with metabolic, immunological, and vascular modulation properties. It helps to induce hyperdynamic circulation in sepsis. Objective: The purpose of the existing research was to determine the value of Pro-adrenomedullin (Pro-ADM) level as a diagnostic marker for NS. Methodology: The study included 2 groups, the case group which included 40 proven septic neonates and the control group which comprised 40 sex and age matched newborns free from sepsis. Blood samples were collected for blood culture and for sera separation for Pro-ADM assay using ELISA. Results: Gram- negative bacteria were the most frequently identified microorganisms (57.5%), with Klebsiella pneumoniae being the most common one (52.5%). Pro-ADM level was statistically significantly higher in septic neonates than controls (P value ≤ 0.001). Also, Pro-ADM level was statistically significantly higher in non-survivor patients than survivors (p value = 0.002). The optimum cut off of Pro-ADM value to discriminate septic and control neonates was 3.36 pmol/L which exhibited a sensitivity, specificity, and accuracy of 97.5 % each in diagnosing NS. Conclusion: Pro-ADM appears to be a useful biomarker in diagnosing NS.