Modern Pediatrics. Ukraine. (2024). 5(141): 43-48. doi: 10.15574/SP.2024.5(141).4348
Orujova P., Sultanova N.
Azerbaijan Medical University, Baku

For citation: Orujova P, Sultanova N. (2024). The role of adenosine monophosphate-activated protein kinase and serum amyloid A proteins in the early diagnosis of neonatal sepsis. Modern Pediatrics. Ukraine. 5(141): 43-48. doi: 10.15574/SP.2024.5(141).4348.
Article received: Jun 11, 2024. Accepted for publication: Sep 09, 2024.

Neonatal sepsis is a leading cause of mortality among newborns globally, with an incidence of 1 per 1,000 live births. Current diagnostic markers such as C-reactive protein (CRP) and procalcitonin (PCT) lack specificity and sensitivity for early diagnosis, highlighting the need for more reliable biomarkers.
The aim of the study is to evaluate the role of adenosine monophosphate-activated protein kinase (AMPK) and serum amyloid A (SAA) proteins as potential biomarkers for the early diagnosis of sepsis in neonates suspected of having the condition.
Materials and methods. A cohort study was conducted involving 143 newborns suspected of sepsis, admitted to the intensive care units within the first 24 hours of life. Clinical evaluations included respiratory distress assessment, chest and abdominal imaging, and brain ultrasound. Blood samples were analyzed for CRP, PCT, AMPK, and SAA levels using enzyme-linked immunosorbent assay (ELISA) kits. Statistical analysis involved Mann-Whitney and independent samples t-tests, as well as receiver operating characteristic (ROC) analysis to determine diagnostic cutoff levels. The nonparametric Spearman rank correlation test (r – the Spearman rank-order correlation coefficient) was used. Differences at p˂0.05 were considered reliable.
Results. Inflammatory markers CRP and PCT were used to confirm sepsis diagnosis in conjunction with clinical assessment. However, 12.8% of infants with PCT >2 ng/mL and 17.5% with CRP >5 mg/mL did not have confirmed sepsis. Conversely, sepsis was confirmed in 63.6% of infants with PCT <2 ng/mL and 53.7% with CRP <5 mg/mL. A significant correlation between AMPK and SAA was observed in 111 infants (r=0.192, p=0.044). The ROC analysis indicated that AMPK and SAA levels below specific thresholds were significant for excluding sepsis.
Conclusion. AMPK and AA levels are promising diagnostic markers for neonatal sepsis, warranting further investigation in larger studies. These biomarkers can improve early diagnosis and reduce unnecessary antibiotic usage, thus improving neonatal outcomes.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of a participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: neonatal sepsis, adenosine monophosphate-activated protein kinase, serum amyloid A, biomarkers, early diagnosis, C-reactive protein, procalcitonin.

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