Serum and cerebrospinal fluid biomarkers for risk stratification of hospitalized neonates and young infants with suspected serious bacterial infections: a secondary analysis of a prospective cohort study
Year: 2026
Type: article
Abstract: Background: Improved risk stratification strategies for neonates and young infants are urgently needed to reduce the substantial mortality burden associated with infectious diseases, particularly in low- and middle-income settings. Evidence supporting the use of host-response biomarkers to predict disease severity in this population remains limited. Methods: We conducted a secondary analysis of a prospective cohort study at a National Reference Neonatology Centre in Morocco and evaluated the prognostic performance of host-response biomarkers measured in serum and cerebrospinal fluid (CSF) to predict in-hospital mortality among hospitalized sick neonates and young infants (<2 months). Twenty-one biomarkers of immune activation, endothelial dysfunction, and neuronal injury were measured using Luminex and compared head-to-head. Results: Among 179 participants with available serum and/or CSF samples included in this analysis, 9% died during hospitalization (11/136 in the serum sample set, and 12/148 in the CSF sample set). In serum, lower concentrations of TRAIL and higher concentrations of Angpt-2, IL-8, and uPAR, were associated with in-hospital death, with TRAIL showing the strongest prognostic performance (AUROC 0.86; 95% CI 0.78-0.93). In CSF, PCT was the strongest predictor of severe progression for in-hospital death (AUROC 0.87; 95% CI 0.80-0.95), whereas higher levels of IL-6, IL-12p70, TNFR1, TREM-1, Angpt-1, NGAL, and NSE were associated with higher odds of probable or laboratory-confirmed meningitis. Discussion: Serum levels of TRAIL showed an exploratory association with disease severity in hospitalized neonates and young infants with suspected serious bacterial infections. Larger multicenter studies are needed to validate these findings using multiple biological matrices, characterize kinetics, and determine whether these markers may have clinical utility for risk stratification in this vulnerable population.
Source: Frontiers in Immunology
Authors: Chaymae El Abbass, Luis Alberto Benegas, Andrea Alemany, Cristina Garcia-Mauriño, Ilham Elouardighi, Imane Zizi, Najat Amalik, Lamya El Laziji, Sobha El Ftouh, Rachid Babi, Khalid Bounagua, Nouhayla Bouali, Sara Ajanovic, Sara Arias, Dan Ouchi, Fio Vialard, David Torres-Fernandez, Pere Millat-Martinez, Diana Barrios, Rosauro Varo, Kevin C. Kain, Ruth Aguilar, Carlota Dobaño, Gemma Moncunill, Houssain Tligui, Bàrbara Baro, Quique Bassat, Amina Barkat
Institutions: Mohammed V University, Centre Hospitalier Ibn Sina, Hospital Clínic de Barcelona, Barcelona Institute for Global Health, Université Mohammed VI des Sciences et de la Santé, Vall d'Hebron Institut de Recerca, Manhiça Health Research Centre, Vall d'Hebron Hospital Universitari, Universitat de Barcelona, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Institut de Recerca Sant Joan de Déu, University of Toronto, Toronto General Hospital, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red, Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Institució Catalana de Recerca i Estudis Avançats, Hospital Sant Joan de Déu Barcelona
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funders: Bill and Melinda Gates Foundation, European Society for Paediatric Infectious Diseases, European Commission, HORIZON EUROPE Framework Programme, Agència de Gestió d'Ajuts Universitaris i de Recerca, Agencia Española de Cooperación Internacional para el Desarrollo, Agencia Estatal de Investigación, European Social Fund
OpenAlex ID: W7222521640