1183 Comparison of Urinary Neutrophil Gelatinase-Associated Lipocalin, C-Reactive Protein and Procalcitonin in Diagnosis of Late Onset Sepsis in Preterm Newborns

Abstract Objective Noninvasive markers have been increasingly used as a diagnostic marker for sepsis detection and monitoring of the disease. The aim of this observational, prospective pilot study was to investigate the diagnostic performance of urinary soluble triggering receptor expressed on myeloid cells (sTREM-1) and urine C-reactive protein (CRP) levels in the late onset neonatal sepsis and to compare them with serum CRP levels. Materials and Methods Sixty-six infants with clinical sepsis were included. Urine sTREM-1 and urine CRP were collected at the diagnosis of late-onset sepsis. All laboratory investigations were also noted from the infants. Results There were no significant differences between characteristics of the infants. Culture-positive neonates had significantly higher urine sTREM-1 than culture-negative neonates (p < 0.001). Using a cut-off point for urine sTREM-1 of 129 pg/mL, the sensitivity was 0.63, the specificity was 0.84, positive predictive value was 0.80, negative predictive value was 0.70. Urine sTREM-1 and urine CRP were recollected on the seventh day of sepsis treatment and it was found that the levels of sTREM-1 and CRP decreased. Conclusion This is the first study in the literature which evaluates the place of urine sTREM-1 and urine CRP in the diagnosis of neonatal sepsis. Urine sTREM-1 and urine CRP may be useful in the diagnosis of sepsis and in evaluating the effect of antibiotic treatment.

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Neutrophil gelatinase-associated lipocalin has a stronger association with serum creatinine than C-reactive protein in patients without sepsis; this relationship is lost in septic patients

Critical Care ◽

10.1186/cc10378 ◽

2011 ◽

Vol 15 (S3) ◽

Author(s):

NJ Glassford ◽

AG Schneider ◽

G Eastwood ◽

L Peck ◽

H Young ◽

...

Keyword(s):

Serum Creatinine ◽

C Reactive Protein ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Reactive Protein ◽

Neutrophil Gelatinase

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Procalcitonin, C-reactive protein, neutrophil gelatinase-associated lipocalin, resistin and the APTT waveform for the early diagnosis of serious bacterial infection and prediction of outcome in critically ill children

PLoS ONE ◽

10.1371/journal.pone.0246027 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246027

Author(s):

Maryke J. Nielsen ◽

Paul Baines ◽

Rebecca Jennings ◽

Sarah Siner ◽

Ruwanthi Kolamunnage-Dona ◽

...

Keyword(s):

Bacterial Infection ◽

Critically Ill Children ◽

Correct Classification ◽

C Reactive Protein ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Reactive Protein ◽

Plasma Ngal ◽

Net Reclassification Improvement ◽

Neutrophil Gelatinase

Objective Bacterial Infections remains a leading cause of death in the Paediatric Intensive Care Unit (PICU). In this era of rising antimicrobial resistance, new tools are needed to guide antimicrobial use. The aim of this study was to investigate the accuracy of procalcitonin (PCT), neutrophil gelatinase-associated lipocalin (NGAL), resistin, activated partial thromboplastin time (aPTT) waveform and C-reactive protein (CRP) for the diagnosis of serious bacterial infection (SBI) in children on admission to PICU and their use as prognostic indicators. Setting A regional PICU in the United Kingdom. Patients Consecutive PICU admissions between October 2010 and June 2012. Measurements Blood samples were collected daily for biomarker measurement. The primary outcome measure was performance of study biomarkers for diagnosis of SBI on admission to PICU based on clinical, radiological and microbiological criteria. Secondary outcomes included durations of PICU stay and invasive ventilation and 28-day mortality. Patients were followed up to day 28 post-admission. Main results A total of 657 patients were included in the study. 92 patients (14%) fulfilled criteria for SBI. 28-day mortality was 2.6% (17/657), but 8.7% (8/92) for patients with SBI. The combination of PCT, resistin, plasma NGAL and CRP resulted in the greatest net reclassification improvement compared to CRP alone (0.69, p<0.005) with 10.5% reduction in correct classification of patients with SBI (p 0.52) but a 78% improvement in correct classification of patients without events (p <0.005). A statistical model of prolonged duration of PICU stay found log-transformed maximum values of biomarkers performed better than first recorded biomarkers. The final model included maximum values of CRP, plasma NGAL, lymphocyte and platelet count (AUC 79%, 95% CI 73.7% to 84.2%). Longitudinal profiles of biomarkers showed PCT levels to decrease most rapidly following admission SBI. Conclusion Combinations of biomarkers, including PCT, may improve accurate and timely identification of SBI on admission to PICU.

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