摘要：Background Neonatal infections annually claim lives of 1.4 millionneonates worldwide.Until now, there is no ideal diagnostic test fordetecting sepsis and thus management of possible sepsis cases oftendepends on clinical algorithm leading to empirical treatment.Thisoften results in unnecessary antibiotic use, which may lead to emergenceof antibiotic resistance.Biomarkers have shown great promisein diagnosis of sepsis and guiding appropriate treatment of neonates.In this study, we conducted a literature review of existing biomarkersto analyze their status for use as a point-of-care diagnostic in developingcountries.Methods PubMed and EMBASE database were searched with keywords,‘infections’, ‘neonates’, and ‘biomarkers’ to retrieve potentiallyrelevant papers from the period 1980 to 2010.Leading hospitals andmanufacturers were communicated to inquire about the cost, laboratoryrequirements and current standing of biomarkers in clinical use.Results The search returned 6407 papers on biomarkers; 65 wereselected after applying inclusion and exclusion criteria.Among thestudies, C-reactive protein (CRP), procalcitonin (PCT) and interleukin6 (IL-6) were the most widely studied biomarkers and were consideredto be most promising for diagnosing neonatal infections.About 90% of the studies were from developed countries; more than50% were from Europe.Conclusions Extensive work is being performed to find the diagnosticand prognostic value of biomarkers.However, the methodologiesand study design are highly variable.Despite numerous researchpapers on biomarkers, their use in clinical setting is limitedto CRP.The methods for detection of biomarkers are far too advancedto be used at the community level where most of the babies are dying.It is important that a harmonized multi-site study is initiated tofind a battery of biomarkers for diagnosis of neonatal infections.
