Pancreatic stone protein as a novel marker for neonatal sepsis

Schlapbach, Luregn J., Graf, Rolf, Woerner, Andreas, Fontana, Matteo, Zimmermann-Baer, Urs, Glauser, David, Giannoni, Eric, Roger, Thierry, Muller, Christoph, Nelle, Mathias and Stocker, Martin (2013) Pancreatic stone protein as a novel marker for neonatal sepsis. Intensive Care Medicine, 39 4: 754-763. doi:10.1007/s00134-012-2798-3


Author Schlapbach, Luregn J.
Graf, Rolf
Woerner, Andreas
Fontana, Matteo
Zimmermann-Baer, Urs
Glauser, David
Giannoni, Eric
Roger, Thierry
Muller, Christoph
Nelle, Mathias
Stocker, Martin
Title Pancreatic stone protein as a novel marker for neonatal sepsis
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
1432-1238
Publication date 2013-04
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s00134-012-2798-3
Open Access Status
Volume 39
Issue 4
Start page 754
End page 763
Total pages 10
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract
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.
Keyword C-reactive protein
Infant
Macrophage migration inhibitory factor
Pancreatic stone protein
Procalcitonin
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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