SEPSIS project: a protocol for studying biomarkers of neonatal sepsis and immune responses of infants in a malaria-endemic region

Nadine Fievet, Sem Ezinmegnon, Gino Agbota, Darius Sossou, Rodolphe Ladekpo, Komi Gbedande, Valerie Briand, Gilles Cottrell, Laurence Vachot, Javier Yugueros Marcos, Alexandre Pachot, Julien Textoris, Sophie Blein, Ulrik Lausten-Thomsen, Achille Massougbodji, Lehila Bagnan, Nicole Tchiakpe, Marceline d'Almeida, Jules Alao, Ida Dossou-Dagba, Pierre Tissieres, SEPSIS study group collaborators, SEPSIS study group, Aurax Fernando, Urbain Ahouayito, Basile Agossou, Caleb Ezinmegnon, Anauel Fortunato, Josué Fiagbenou, Djamirou Dossa, Dramane Abdou, Canisius Fantodji, Nawal Sare, Wilisto Bara, Razack Monde, Erasme Gbagidi, Larissa Allokpe, Armand Housemenou, Landry Assongba, Manfred Accrombessi, Florent Kouhouenou, Armand Hounsemenou, Amour Ridagba, Christiane Aguemon, Dissou Affolabi, Réné Perrin, Benjamin Hounkpatin, Dossou Dagba, Luis Augusto, Sophie Thibault, François Bartolo, Marine Mommert, Karen Brengel-Pesce, Nadine Fievet, Sem Ezinmegnon, Gino Agbota, Darius Sossou, Rodolphe Ladekpo, Komi Gbedande, Valerie Briand, Gilles Cottrell, Laurence Vachot, Javier Yugueros Marcos, Alexandre Pachot, Julien Textoris, Sophie Blein, Ulrik Lausten-Thomsen, Achille Massougbodji, Lehila Bagnan, Nicole Tchiakpe, Marceline d'Almeida, Jules Alao, Ida Dossou-Dagba, Pierre Tissieres, SEPSIS study group collaborators, SEPSIS study group, Aurax Fernando, Urbain Ahouayito, Basile Agossou, Caleb Ezinmegnon, Anauel Fortunato, Josué Fiagbenou, Djamirou Dossa, Dramane Abdou, Canisius Fantodji, Nawal Sare, Wilisto Bara, Razack Monde, Erasme Gbagidi, Larissa Allokpe, Armand Housemenou, Landry Assongba, Manfred Accrombessi, Florent Kouhouenou, Armand Hounsemenou, Amour Ridagba, Christiane Aguemon, Dissou Affolabi, Réné Perrin, Benjamin Hounkpatin, Dossou Dagba, Luis Augusto, Sophie Thibault, François Bartolo, Marine Mommert, Karen Brengel-Pesce

Abstract

Introduction: Neonatal sepsis outreaches all causes of neonatal mortality worldwide and remains a major societal burden in low and middle income countries. In addition to limited resources, endemic morbidities, such as malaria and prematurity, predispose neonates and infants to invasive infection by altering neonatal immune response to pathogens. Nevertheless, thoughtful epidemiological, diagnostic and immunological evaluation of neonatal sepsis and the impact of gestational malaria have never been performed.

Methods and analysis: A prospective longitudinal multicentre follow-up of 580 infants from birth to 3 months of age in urban and suburban Benin will be performed. At delivery, and every other week, all children will be examined and clinically evaluated for occurrence of sepsis. At delivery, cord blood systematic analysis of selected plasma and transcriptomic biomarkers (procalcitonin, interleukin (IL)-6, IL-10, IP10, CD74 and CX3CR1) associated with sepsis pathophysiology will be evaluated in all live births as well as during the follow-up, and when sepsis will be suspected. In addition, whole blood response to selected innate stimuli and extensive peripheral blood mononuclear cells phenotypic characterisation will be performed. Reference intervals specific to sub-Saharan neonates will be determined from this cohort and biomarkers performances for neonatal sepsis diagnosis and prognosis tested.

Ethics and dissemination: Ethical approval has been obtained from the Comité d'Ethique de la Recherche - Institut des Sciences Biomédicales Appliquées (CER-ISBA 85 - 5 April 2016, extended on 3 February 2017). Results will be disseminated through international presentations at scientific meetings and publications in peer-reviewed journals.

Trial registration number: ClinicalTrials.gov registration number: NCT03780712.

Keywords: immunology; neonatal intensive & critical care; neonatology; paediatric infectious disease & immunisation.

Conflict of interest statement

Competing interests: JYM, LV, JT, AP and SB are employed by an in vitro diagnostic company, bioMérieux SA. The remaining authors declare that this research was conducted in the absence of any commercial or financial relationship that could cause potential conflict of interest.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Geographical location of the six study centres in the Sô-Ava, Abomey-Calavi and Cotonou districts in Benin.
Figure 2
Figure 2
Schematic design of the sepsis study illustrating inclusion, planned biological analysis and follow-up time points.

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