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Objective:  To assess serial methemoglobin (MetHb) levels in preterm infants as a possible diagnostic method for late-onset sepsis (LOS).  Methods:  Preterm infants were assigned into two groups: those with culture-proven LOS and controls. Serial MetHb levels were measured.  Results:  The MetHb values of the LOS group were found to be significantly increased ( p  &lt; 0.001). The cutoff value for the detection of LOS was calculated as MetHb &gt; 1.75%, optimized for a sensitivity of 81.9% and specificity of 90%. After antimicrobial therapy, MetHb values were found to decrease significantly ( p  &lt; 0.001). MetHb had an AUC of 0.810 for mortality using the calculated cutoff of &gt;2% ( p  &lt; 0.005).  Conclusions:  MetHb levels increase at the onset of LOS and decrease following treatment. MetHb can be added to other sepsis biomarkers as a rapid infectious process indicator for preterm neonates. MetHb &gt; 2% is associated with LOS mortality.

Can We Estimate Late-Onset Sepsis by Serial Methemoglobin Levels? An Observational Study in Preterm Neonates