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Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study

Despite the high prevalence of late-onset sepsis (LOS) in neonatal intensive care units, a reliable diagnosis remains difficult. This prospective, multicenter cohort study aimed to identify biomarkers early to rule out the diagnosis of LOS in 230 neonates ≥7 days of life with signs of suspected LOS....

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Autores principales: Pons, Sylvie, Trouillet-Assant, Sophie, Subtil, Fabien, Abbas-Chorfa, Fatima, Cornaton, Elise, Berthiot, Amélie, Galletti, Sonia, Plat, Aurélie, Rapin, Stephanie, Trapes, Laurene, Generenaz, Laurence, Brengel-Pesce, Karen, Callies, Arnaud, Plaisant, Franck, Claris, Olivier, Portefaix, Aurelie, Flamant, Cyril, Butin, Marine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10295850/
https://www.ncbi.nlm.nih.gov/pubmed/37371798
http://dx.doi.org/10.3390/biomedicines11061703
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author Pons, Sylvie
Trouillet-Assant, Sophie
Subtil, Fabien
Abbas-Chorfa, Fatima
Cornaton, Elise
Berthiot, Amélie
Galletti, Sonia
Plat, Aurélie
Rapin, Stephanie
Trapes, Laurene
Generenaz, Laurence
Brengel-Pesce, Karen
Callies, Arnaud
Plaisant, Franck
Claris, Olivier
Portefaix, Aurelie
Flamant, Cyril
Butin, Marine
author_facet Pons, Sylvie
Trouillet-Assant, Sophie
Subtil, Fabien
Abbas-Chorfa, Fatima
Cornaton, Elise
Berthiot, Amélie
Galletti, Sonia
Plat, Aurélie
Rapin, Stephanie
Trapes, Laurene
Generenaz, Laurence
Brengel-Pesce, Karen
Callies, Arnaud
Plaisant, Franck
Claris, Olivier
Portefaix, Aurelie
Flamant, Cyril
Butin, Marine
author_sort Pons, Sylvie
collection PubMed
description Despite the high prevalence of late-onset sepsis (LOS) in neonatal intensive care units, a reliable diagnosis remains difficult. This prospective, multicenter cohort study aimed to identify biomarkers early to rule out the diagnosis of LOS in 230 neonates ≥7 days of life with signs of suspected LOS. Blood levels of eleven protein biomarkers (PCT, IL-10, IL-6, NGAL, IP-10, PTX3, CD14, LBP, IL-27, gelsolin, and calprotectin) were measured. Patients received standard of care blinded to biomarker results, and an independent adjudication committee blinded to biomarker results assigned each patient to either infected, not infected, or unclassified groups. Performances of biomarkers were assessed considering a sensitivity of at least 0.898. The adjudication committee classified 22% of patients as infected and all of these received antibiotics. A total of 27% of the not infected group also received antibiotics. The best biomarkers alone were IL-6, IL-10, and NGAL with an area under the curve (95% confidence interval) of 0.864 (0.798–0.929), 0.845 (0.777–0.914), and 0.829 (0.760–0.898), respectively. The best combinations of up to four biomarkers were PCT/IL-10, PTX3/NGAL, and PTX3/NGAL/gelsolin. The best models of biomarkers could have identified not infected patients early on and avoided up to 64% of unjustified antibiotics. At the onset of clinical suspicion of LOS, additional biomarkers could help the clinician in identifying non-infected patients.
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spelling pubmed-102958502023-06-28 Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study Pons, Sylvie Trouillet-Assant, Sophie Subtil, Fabien Abbas-Chorfa, Fatima Cornaton, Elise Berthiot, Amélie Galletti, Sonia Plat, Aurélie Rapin, Stephanie Trapes, Laurene Generenaz, Laurence Brengel-Pesce, Karen Callies, Arnaud Plaisant, Franck Claris, Olivier Portefaix, Aurelie Flamant, Cyril Butin, Marine Biomedicines Article Despite the high prevalence of late-onset sepsis (LOS) in neonatal intensive care units, a reliable diagnosis remains difficult. This prospective, multicenter cohort study aimed to identify biomarkers early to rule out the diagnosis of LOS in 230 neonates ≥7 days of life with signs of suspected LOS. Blood levels of eleven protein biomarkers (PCT, IL-10, IL-6, NGAL, IP-10, PTX3, CD14, LBP, IL-27, gelsolin, and calprotectin) were measured. Patients received standard of care blinded to biomarker results, and an independent adjudication committee blinded to biomarker results assigned each patient to either infected, not infected, or unclassified groups. Performances of biomarkers were assessed considering a sensitivity of at least 0.898. The adjudication committee classified 22% of patients as infected and all of these received antibiotics. A total of 27% of the not infected group also received antibiotics. The best biomarkers alone were IL-6, IL-10, and NGAL with an area under the curve (95% confidence interval) of 0.864 (0.798–0.929), 0.845 (0.777–0.914), and 0.829 (0.760–0.898), respectively. The best combinations of up to four biomarkers were PCT/IL-10, PTX3/NGAL, and PTX3/NGAL/gelsolin. The best models of biomarkers could have identified not infected patients early on and avoided up to 64% of unjustified antibiotics. At the onset of clinical suspicion of LOS, additional biomarkers could help the clinician in identifying non-infected patients. MDPI 2023-06-13 /pmc/articles/PMC10295850/ /pubmed/37371798 http://dx.doi.org/10.3390/biomedicines11061703 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pons, Sylvie
Trouillet-Assant, Sophie
Subtil, Fabien
Abbas-Chorfa, Fatima
Cornaton, Elise
Berthiot, Amélie
Galletti, Sonia
Plat, Aurélie
Rapin, Stephanie
Trapes, Laurene
Generenaz, Laurence
Brengel-Pesce, Karen
Callies, Arnaud
Plaisant, Franck
Claris, Olivier
Portefaix, Aurelie
Flamant, Cyril
Butin, Marine
Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title_full Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title_fullStr Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title_full_unstemmed Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title_short Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study
title_sort performance of 11 host biomarkers alone or in combination in the diagnosis of late-onset sepsis in hospitalized neonates: the prospective emeraude study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10295850/
https://www.ncbi.nlm.nih.gov/pubmed/37371798
http://dx.doi.org/10.3390/biomedicines11061703
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