Pancreatic stone protein as a novel marker for neonatal sepsis.

Détails

ID Serval
serval:BIB_5694EF7D83D0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Pancreatic stone protein as a novel marker for neonatal sepsis.
Périodique
Intensive Care Medicine
Auteur⸱e⸱s
Schlapbach L.J., Graf R., Woerner A., Fontana M., Zimmermann-Baer U., Glauser D., Giannoni E., Roger T., Müller C., Nelle M., Stocker M.
ISSN
1432-1238 (Electronic)
ISSN-L
0342-4642
Statut éditorial
Publié
Date de publication
2013
Volume
39
Numéro
4
Pages
754-763
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish. PDF type: PEDIATRIC ORIGINAL
Résumé
PURPOSE: Early-onset sepsis (EOS) is one of the main causes for the admission of newborns to the neonatal intensive care unit. However, traditional infection markers are poor diagnostic markers of EOS. Pancreatic stone protein (PSP) is a promising sepsis marker in adults. The aim of this study was to investigate whether determining PSP improves the diagnosis of EOS in comparison with other infection markers.
METHODS: This was a prospective multicentre study involving 137 infants with a gestational age of >34 weeks who were admitted with suspected EOS. PSP, procalcitonin (PCT), soluble human triggering receptor expressed on myeloid cells-1 (sTREM-1), macrophage migration inhibitory factor (MIF) and C-reactive protein (CRP) were measured at admission. Receiver-operating characteristic (ROC) curve analysis was performed.
RESULTS: The level of PSP in infected infants was significantly higher than that in uninfected ones (median 11.3 vs. 7.5 ng/ml, respectively; p = 0.001). The ROC area under the curve was 0.69 [95 % confidence interval (CI) 0.59-0.80; p < 0.001] for PSP, 0.77 (95 % CI 0.66-0.87; p < 0.001) for PCT, 0.66 (95 % CI 0.55-0.77; p = 0.006) for CRP, 0.62 (0.51-0.73; p = 0.055) for sTREM-1 and 0.54 (0.41-0.67; p = 0.54) for MIF. PSP independently of PCT predicted EOS (p < 0.001), and the use of both markers concomitantly significantly increased the ability to diagnose EOS. A bioscore combining PSP (>9 ng/ml) and PCT (>2 ng/ml) was the best predictor of EOS (0.83; 95 % CI 0.74-0.93; p < 0.001) and resulted in a negative predictive value of 100 % and a positive predictive value of 71 %.
CONCLUSIONS: In this prospective study, the diagnostic performance of PSP and PCT was superior to that of traditional markers and a combination bioscore improved the diagnosis of sepsis. Our findings suggest that PSP is a valuable biomarker in combination with PCT in EOS.
Pubmed
Web of science
Création de la notice
25/04/2013 16:54
Dernière modification de la notice
20/08/2019 14:10
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