T6A Biomarker for Detection of Bacterial Infection in Newborn Infants (T6ASepsis)

June 25, 2026 updated by: Lorenz Auer-Hackenberg, Salzburger Landeskliniken
This study aims to assess the efficacy of a new biomarker, N6-threonylcarbamoyladenosine (t6A), for the early diagnosis of Early-Onset Sepsis (EOS) in newborns.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

This study aims to assess the efficacy of a new biomarker, N6-threonylcarbamoyladenosine (t6A), for the early diagnosis of Early-Onset Sepsis (EOS) in newborns.

Background:

EOS is a significant concern for newborns, especially preterm infants, with a high mortality rate. Current diagnostic methods, like blood cultures, have limitations due to non-specific clinical presentations and slow turnaround times. Existing biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), and Interleukin-6 (IL-6) also have limitations in terms of early detection and specificity.

Objective:

To facilitate the early diagnosis of EOS in newborns at risk for bacterial infection on day one.

Hypotheses:

t6A levels will rapidly increase in newborns with suspected EOS, allowing for early and precise identification from non-EOS neonates.

Circulating t6A will demonstrate higher diagnostic accuracy (positive and negative predictive values) compared to existing biomarkers like PCT, CRP, and IL-6.

Methodology:

This will be an open-label prospective cohort study conducted at the Private Medical University of Salzburg, Austria.

Study Population: Newborn infants requiring blood testing for suspected bacterial infection or routine screening who meet specific inclusion criteria and whose caregivers provide informed consent. Exclusion criteria include refusal to participate or current antibiotic treatment.

Control Group: 50 healthy newborn infants undergoing routine blood testing for other reasons (e.g., thyroid hormone testing).

Data Collection: Blood samples (20 µl using Neoteryx® Microsampling kit) will be collected via heel prick during routine patient care within the first 12 hours of life. Clinical and blood value data will also be collected. Samples will be analyzed for t6A, CBC, CRP, PCT, and IL-6.

Sepsis Confirmation: Bacterial infection will be confirmed using adapted NEO-KISS criteria, which include clinical sepsis and microbiologically confirmed sepsis (with and without coagulase-negative staphylococci).

Timeline: Patient enrollment will occur between February 1, 2026, and January 31, 2029.

Sample Size: A minimum of 210 participants (105 sepsis, 105 control) is planned to achieve adequate statistical power, based on AUC values of t6A and PCT from a previous study.

Data Management: Patient data will be anonymized with three-digit identification numbers. Blood samples will be sent to Pharm-analyt for testing.

Analysis/Statistics: Data will be analyzed using R. Primary outcome (differences in t6A levels) will be assessed using t-tests or Wilcoxon tests. Secondary outcomes (comparison of AUCs for t6A vs. IL-6 and CRP) will use DeLong's test with Bonferroni-Holms correction.

Study Type

Observational

Enrollment (Estimated)

210

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Newborn infants

Description

Inclusion Criteria:

  • Newborn infants who require blood testing for screening for bacterial infection OR treating physician suspects bacterial infection in newborn infant
  • Signed informed consent form

Exclusion Criteria:

  1. Refusal to participate in study or not providing written informed consent by caregivers/parents
  2. Antibiotic treatment of any kind.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Controls
Patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants with Clinical Sepsis
Time Frame: 12 Hours

1. Clinical Sepsis (no pathogen detected):

All of:

  • Initiation of adequate antimicrobial therapy ≥5 days by attending physician
  • No pathogen detected in blood culture or not tested
  • No clear infection elsewhere

AND at least 2 of:

  • Fever (>38°C) or temperature instability or hypothermia (<36.5°C)
  • Tachycardia (>200/min) or new/increased bradycardia (<80/min)
  • Capillary refill >2s
  • New/increased apnoea (>20 s)
  • Unexplained metabolic acidosis (BE < -10 mval/l)
  • New onset hyperglycaemia (>140 mg/dl)
  • Other sepsis signs (skin color, abnormal labs, increased oxygen demand, unstable status, apathy)
12 Hours
Number of participants with Microbiologically Confirmed Sepsis (excluding coagulase negative staphylococci CNS)
Time Frame: 12 Hours

Microbiologically Confirmed Sepsis (excluding coagulase negative staphylococci CNS)

AND at least 2 of:

  • Fever (>38°C) or temperature instability or hypothermia (<36.5°C)
  • Tachycardia (>200/min) or new/increased bradycardia (<80/min)
  • Capillary refill >2s
  • New/increased apnoea (>20 s)
  • Unexplained metabolic acidosis (BE < -10 mval/l)
  • New onset hyperglycaemia (>140 mg/dl)
  • Other sepsis signs (skin color, abnormal labs, increased oxygen demand, unstable status, apathy)
12 Hours
Number of participants with Microbiologically confirmed Sepsis with CNS
Time Frame: 12 Hours

Microbiologically confirmed sepsis with CNS as the sole pathogen One lab value (without other plausible cause)

  • CRP >2mg/dl
  • I/T ratio > 0.2
  • Platelets <100/nl
  • Leukocytes <5/nl

AND at least 2 of:

  • Fever (>38°C) or temperature instability or hypothermia (<36.5°C)
  • Tachycardia (>200/min) or new/increased bradycardia (<80/min)
  • Capillary refill >2s
  • New/increased apnoea (>20 s)
  • Unexplained metabolic acidosis (BE < -10 mval/l)
  • New onset hyperglycaemia (>140 mg/dl)
  • Other sepsis signs (skin color, abnormal labs, increased oxygen demand, unstable status, apathy)
12 Hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Salzburger Landeskliniken

Collaborators

Wroclaw Medical University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

January 31, 2029

Study Completion (Estimated)

January 31, 2029

Study Registration Dates

First Submitted

June 2, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

June 26, 2026

Study Record Updates

Last Update Posted (Actual)

June 26, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • T6A_NewbornSepsis_V6

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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