Abstract | BACKGROUND: METHODS: This is a prospective observational study of 136 neonates who underwent ≥1 sepsis evaluation at >72 h of age. Urine was obtained at the time of sepsis evaluation to measure UNGAL concentration. Using generalized estimating equations controlling for gender, gestational and postnatal age, acute kidney injury, and within-patient correlations, pair-wise contrasts between mean log UNGAL concentrations of infants with negative sepsis evaluations vs. culture-positive sepsis and presumed sepsis were assessed. Discrimination characteristics at several UNGAL cutoff concentrations were assessed using receiver-operating characteristic curves. RESULTS: The predicted mean log UNGAL values of culture-positive sepsis and presumed sepsis vs. negative sepsis evaluations differed significantly (P < 0.001 and P = 0.02, respectively). At a cutoff ≥ 50 ng/ml, UNGAL discriminated between culture-positive sepsis and culture-negative sepsis evaluations with sensitivity = 86%, specificity = 56%, positive predictive value = 41%, negative predictive value = 92%, and number needed to treat = 3. CONCLUSION: UNGAL is a noninvasive biomarker with high negative predictive value at the time of late-onset sepsis evaluation in neonates and could be a useful adjunct to traditional components of sepsis evaluations.
|
Authors | Jennifer M Pynn, Elvira Parravicini, Lisa Saiman, David A Bateman, Jonathan M Barasch, John M Lorenz |
Journal | Pediatric research
(Pediatr Res)
Vol. 78
Issue 1
Pg. 76-81
(Jul 2015)
ISSN: 1530-0447 [Electronic] United States |
PMID | 25806716
(Publication Type: Journal Article, Observational Study, Research Support, N.I.H., Extramural)
|
Chemical References |
- Acute-Phase Proteins
- Biomarkers
- LCN2 protein, human
- Lipocalin-2
- Lipocalins
- Proto-Oncogene Proteins
|
Topics |
- Acute Kidney Injury
(physiopathology)
- Acute-Phase Proteins
(urine)
- Biomarkers
(urine)
- Female
- Gestational Age
- Hospitalization
- Humans
- Infant, Newborn
- Intensive Care, Neonatal
- Lipocalin-2
- Lipocalins
(urine)
- Male
- Predictive Value of Tests
- Prospective Studies
- Proto-Oncogene Proteins
(urine)
- ROC Curve
- Sensitivity and Specificity
- Sepsis
(diagnosis, urine)
|