Articles, Issue 4/2023

Innovative Inflammatory Markers in Septic and Critically ill Children

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A. Hadzhieva-Hristova, T. Stoeva, V. Iotova


Abstract

Critical septic conditions caused by infectious pathogens are one of the leading causes of death in
children globally. The lack of introduced algorithms for rapid assessment of the condition of these
patients, the use of inflammatory markers with low specificity and sensitivity and the use of standard
microbiological methods pose a risk of delaying the diagnosis and treatment in children with infectious
complications. The aim of this scientific review is to create and test a convenient algorithm for early
assessment, diagnosis and treatment of septic conditions in children.  It will be assessed the
physiological condition of patients using pSOFA, PRISM III and IV scores and the risk of mortality will be
calculated also. The routine biochemical parameters of inflammation, procalcitonin will be compared with
the new ones. Innovative markers of inflammation will be studied – Presepsin, soluble mannose receptor
(sMR) by ELISA method for research purposes.
An innovative and rapid method with high sensitivity and specificity (MALDI-TOF-MS) for the species
identification of the pathogens will be performed, based on microbial protein analysis, incl. direct
identification of the causative agent in the blood sample within 1- 2 hours. As a result, it is expected: to
create a comprehensive assessment of critical and septic conditions in children by using innovative scores
for the first time in Bulgaria; to find a correlation between the effectiveness of new inflammatory laboratory markers with the old ones and to choose the most appropriate combination of markers for an early detection of inflammation in the course of sepsis development in children; to improve the diagnostic process of microbial identification by using an innovative method for early detection of the infectious pathogen associated with the septic condition. More importantly, it will help the prevention, prognosis and will improve the therapeutic approach in children with septic and critical conditions.    
Key words: sepsis, children, MALDI-TOF-MS, procalcitonin, sМR, presepsin

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Address for correspondence:

First children’s clinic with a children’s department
for intensive treatment
UMHAT “Sveta Marina” – Varna
1, “Hristo Smirnenski”, Str.
9010, Varna, Bulgaria
e-mail: hadzhieva.adriana@gmail.com