Finally—a diagnostic marker for neonatal sepsis?

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Neonatal sepsis is a feared but relatively infrequent problem in the developed world. The risk of missing a case of sepsis results in many infants receiving evaluations and antibiotics. The standard assessments that include various absolute white blood cell counts, platelet counts, and C-reactive protein are poor predictors of positive blood cultures. In this issue of The Journal, Chaaban et al have tested Inter-alpha Inhibitor Proteins (IaIp) as indicators of sepsis in 573 infants with suspected sepsis (45 with positive blood cultures). These serine protease inhibitors decrease in plasma with high sensitivity and specifically in infants with sepsis. With further testing, perhaps a useful and reliable diagnostic marker will become available.

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