Discovery and Validation of Serum Metabolic Signature of Neonatal Sepsis

Abstract Better diagnostic biosignature is essential for neonatal sepsis. In this report, we identified a diagnostic serum metabolite signature for neonatal sepsis cases by mass spectrometry-based profiling of serum samples from two discovery cohorts (set-I/-II: n=71/269) of sepsis patients (culture positive or negative:CP/CN) and controls (healthy:HC, no-sepsis:NS) and validated in an independent cross-sectional (n=60) and a longitudinal cohort (n=100). The AUC of ROC of the identified six metabolite signature (1,5-Anhydro-D-sorbitol-Lactic-acid-Malic-acid-Myo-inositol-Phenylalanine-Lysine) predicted CP or CN from HC with an accuracy of >0.97 and from NS 0.84 and 0.64, respectively. The deregulated serum metabolites reverted to the HC levels in the longitudinally followed-up neonates completing the therapeutic intervention. Translation of the serum metabolite signature into an easily deployable diagnostic blood test for neonatal sepsis has the potential to quicker and more appropriate decision making.