Abstract:
Neonatal sepsis is known as a clinical syndrome that is character-
ized by signs or symptoms of infection within the first 28 days fol-
lowing delivery, and it can be confirmed by the isolation of the
causative pathogen from the blood [1,2]. It is divided into 2 catego-
ries: early-onset (within the first 72 hours from presentation) and
late-onset (>72 hours) [3,4]. Based on a recent global estimate from
over 14 countries, neonatal sepsis occurred in 29,608 cases out of
2,797,879 live births over a 10-year period (2009−2018), with
an incidence of 3930 cases per 100,000 live births. It is also associated
with a considerably high mortality rate of 17.6% (ranging from
10.3%−28.6%) worldwide [5]. Many risk factors are contributed to
high mortality in neonates with sepsis, including lower Apgar scores,
septic shock, mechanical ventilation, umbilical catheterization, neu-
tropenia, severe thrombocytopenia, and carbapenem-resistant
microorganisms [6]
Due to the presentation of nonspecific signs and symptoms of
infection, the diagnosis of neonatal sepsis poses a challenge to health-
care practitioners [7,8], which further affects how quickly the treat-
ment plan is initiated and the prognosis in this patient population
[9]. Therefore, to minimize the risk of negative outcomes (namely
progression or mortality), researchers have suggested the use of “bio-
markers” that would help in the diagnosis of sepsis [9,10]. Based on
the definition provided by the National Institute of Health (NIH), bio-
markers are considered “indicators” that can be objectively measured
to either indicate the presence of a disease or identify the response to
a certain therapeutic drug. In the case of neonatal sepsis, both procal-
citonin and C-reactive protein (CRP) are frequently investigated bio-
markers; however, they are associated with limited diagnostic value
[11]. To overcome those limitations, the introduction of novel
