Worldwide 15 million infants each year are born preterm and 1.3 million infants suffer from sepsis, a life-threatening bacterial bloodstream infection. Preterm infants are susceptible to sepsis and this is highly dependent on gestational age (GA) and most frequent during the neonatal period (28 days from birth). Infants who survive may suffer permanent disabilities due to organ damage resulting from either the infection itself or from the inflammatory responses. Despite established epidemiological and clinical risk factors for sepsis in preterm infants, the developmental maturation events of preterm immune system remain largely understudied.
One of the greatest challenges is to collect longitudinal samples from the neonates for immune cell analysis. The presentation will highlight results of a prospective observational study which recruited 129 very preterm infants (<30 weeks GA) of which 43 developed late-onset sepsis (LOS), and 20 healthy term infants born at King Edward Memorial Hospital, Perth, Australia. This study used seven colour flow cytometry to characterise peripheral blood innate cells (monocytes and dendritic) and adaptive T lymphocytes (regulatory T cells and δγT cells) at days of life 1, 7, 14, 21, and 28. The methods for flow cytometry data analysis included traditional manual gating and automated gating (clustering and dimensionality reduction) to overcome the risk of bias associated with traditional method.
The results from this study will provide vital information on the differences in characteristics of immune cells of preterm infants compared to term infants. Furthermore, the developmental trends of immune cells will be compared between sepsis and no-sepsis preterm infants. The findings will provide the foundation for larger studies for targeted immune therapeutics that will globally reduce the occurrence of sepsis in neonates.