Host-response biomarkers for diagnosis of late-onset septicemia and necrotizing enterocolitis in preterm infants
| Autor: | Hugh Simon Lam, Karen Li, Hon Ming Cheung, Rossa W.K. Chiu, Eddy W. Y. Ng, Kit Man Chui, Joseph J.Y. Sung, Yuk Ming Dennis Lo, Pak Cheung Ng, Terence C.W. Poon, Tai Fai Fok, Irene Ling Ang, Raymond Pui On Wong |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Proteomics medicine.medical_specialty medicine.drug_class Antibiotics Late onset Infant Premature Diseases Sepsis Enterocolitis Necrotizing Internal medicine Humans Medicine Serum amyloid A Biomarker discovery Prospective cohort study Intensive care medicine business.industry Infant Newborn Blood Proteins General Medicine medicine.disease Apolipoproteins Technical Advance Necrotizing enterocolitis Female business Biomarkers Cohort study |
| Zdroj: | Journal of Clinical Investigation |
| ISSN: | 0021-9738 |
| DOI: | 10.1172/jci40196 |
| Popis: | Preterm infants are highly susceptible to life-threatening infections that are clinically difficult to detect, such as late-onset septicemia and necrotizing enterocolitis (NEC). Here, we used a proteomic approach to identify biomarkers for diagnosis of these devastating conditions. In a case-control study comprising 77 sepsis/NEC and 77 nonsepsis cases (10 in each group being monitored longitudinally), plasma samples collected at clinical presentation were assessed in the biomarker discovery and independent validation phases. We validated the discovered biomarkers in a prospective cohort study with 104 consecutively suspected sepsis/NEC episodes. Proapolipoprotein CII (Pro-apoC2) and a des-arginine variant of serum amyloid A (SAA) were identified as the most promising biomarkers. The ApoSAA score computed from plasma apoC2 and SAA concentrations was effective in identifying sepsis/NEC cases in the case-control and cohort studies. Stratification of infants into different risk categories by the ApoSAA score enabled neonatologists to withhold treatment in 45% and enact early stoppage of antibiotics in 16% of nonsepsis infants. The negative predictive value of this antibiotic policy was 100%. The ApoSAA score could potentially allow early and accurate diagnosis of sepsis/NEC. Upon confirmation by further multicenter trials, the score would facilitate rational prescription of antibiotics and target infants who require urgent treatment. |
| Databáze: | OpenAIRE |
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