Modern Pediatrics. Ukraine. (2026).4(156): 20-30. doi: 10.15574/SP.2026.4(156).2030
Huseynova N. F.¹, Rahimova N. J.², Gafarov I. A.
¹Scientific Research Institute of Pediatrics, Baku, Azerbaijan
²Azerbaijan Medical University, Bak
³Azerbaijan State Advanced Training Institute for Doctors, Baku

For citation: Huseynova NF, Rahimova NJ, Gafarov IA. (2026). Inflammatory biomarkers in neonatal bacterial infections: diagnostic value of presepsin and interleukin-33. Modern Pediatrics. Ukraine. 4(156): 20-30. doi: 10.15574/SP.2026.4(156).2030.
Article received: Mar 30, 2026. Accepted for publication: May 12, 2026.

Aim – to evaluate the diagnostic significance of the inflammatory biomarkers such as presepsin and interleukin-33 (IL-33) in preterm newborns with bacterial infections and to compare their diagnostic performance with that of traditional inflammatory markers.
Materials and methods. A prospective study was conducted involving 111 preterm newborns treated in neonatal intensive care and pathology units between 2021 and 2024. The Study group consisted of 85 preterm infants with bacterial infections (neonatal pneumonia and sepsis), while the Control group included 26 conditionally healthy newborns. All patients underwent clinical and laboratory examinations, including the assessment of hematological parameters, as well as levels of C-reactive protein, procalcitonin, lactate, presepsin, and IL-33. Presepsin and IL-33 levels were determined using the enzyme-linked immunosorbent assay (ELISA). The clinical severity was assessed using the nSOFA and NEOMOD scoring systems. Statistical analysis was performed using ROC analysis and non-parametric methods.
Results. Preterm infants with bacterial infections exhibited a pronounced systemic inflammatory response, alterations in hematological parameters, and a high incidence of multiple organ dysfunction. Compared with the Control group, presepsin levels increased 7.6-fold, whereas IL-33 levels increased more than sevenfold. ROC analysis demonstrated that presepsin had the highest diagnostic accuracy, followed by IL-33. Both biomarkers demonstrated high sensitivity (91.2%) and specificity (100%), indicating their excellent diagnostic performance in bacterial infections among preterm infants.
Conclusions. Presepsin and IL-33 demonstrated excellent diagnostic performance and represent promising complementary biomarkers for the early diagnosis of bacterial infections in preterm newborns. Their combined assessment with traditional inflammatory markers and organ dysfunction scoring systems (nSOFA and NEOMOD) may improve the accuracy of early diagnosis and risk stratification in neonatal intensive care.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent for participation was obtained from the mothers.
The authors declare no conflict of interest.
Keywords: early diagnosis, preterm infants, neonatal bacterial infection, presepsin, interleukin-33, biomarkers.

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