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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....
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-10295850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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