Evaluating Serum Ferritin as a Diagnostic Marker in Confirmed Bacterial Infections: An Observational Analysis

Category	Detail
Condition	Neonatal sepsis, a life-threatening organ dysfunction due to bacterial infection within first 28 days of life
Key Mechanisms	Dysregulated host response to infection; serum ferritin as an acute-phase protein elevated in inflammation and infection
Target Population	Neonates admitted to NICU with suspected sepsis, including preterm and low birth weight infants
Care Setting	Level III Neonatal Intensive Care Unit in a resource-limited hospital setting in India

Neonatal sepsis diagnosis is challenging due to nonspecific clinical signs and limited sensitivity of blood culture.
Current septic screen includes total leukocyte count, absolute neutrophil count, immature-to-mature neutrophil ratio, micro-ESR, and CRP but has limited diagnostic accuracy.
Serum ferritin, an acute-phase reactant elevated in various infections, is evaluated for its diagnostic utility in culture-confirmed neonatal sepsis.

Use blood culture as the gold standard for neonatal sepsis diagnosis despite sensitivity limitations.
Employ a composite septic screen (total leukocyte count, absolute neutrophil count, immature-to-mature neutrophil ratio, micro-ESR, CRP) for clinical diagnosis.
Consider serum ferritin measurement as a potential adjunct marker to improve diagnostic accuracy.

Initiate antibiotic therapy promptly after sepsis evaluation and sample collection.
Avoid overreliance on septic screen alone to reduce unnecessary empirical antibiotic use and associated risks.

Repeat laboratory investigations including septic screen and serum ferritin at 24–72 hours based on clinical judgment and treatment response.

Empirical antibiotic overuse can disrupt neonatal gut microbiota, increase mortality, impair neurodevelopment, and promote multidrug-resistant organisms.

Neonates with suspected sepsis admitted to NICU in a resource-limited Indian hospital.

Empirical antibiotic use is common but should be guided by improved diagnostic markers like serum ferritin to avoid overuse.

Collect blood culture and laboratory markers prior to antibiotic initiation for accurate diagnosis.
Use standardized clinical and laboratory protocols for sepsis evaluation in neonates.
Incorporate serum ferritin measurement alongside existing septic screen parameters to enhance diagnostic sensitivity and specificity.
Monitor neonates closely with repeat testing to assess treatment response and adjust management accordingly.
Limit empirical antibiotic exposure by improving diagnostic accuracy to reduce adverse outcomes.

Clinical Scorecard: Evaluating Serum Ferritin as a Diagnostic Marker in Confirmed Bacterial Infections: An Observational Analysis