Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection
Abstract Early bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging bioma...
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doaj-b25a115748d54f5a84a791ac14fc1a4e2021-06-06T11:35:07ZengNature Publishing GroupScientific Reports2045-23222021-05-011111910.1038/s41598-021-90894-0Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infectionToh Leong Tan0Christabel Wan-li Kang1Kai Shen Ooi2Swee Thian Tan3Nurul Saadah Ahmad4Dian Nasriana Nasuruddin5Azlin Ithnin6Khaizurin Tajul Arifin7Lee Yook Heng8Nurul Izzaty Hassan9Kok Beng Gan10Hui-min Neoh11Department of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Emergency Medicine, Tengku Ampuan Rahimah Hospital, Ministry of HealthDepartment of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Emergency Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Pathology, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Pathology, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Biochemistry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan MalaysiaDepartment of Chemical Sciences, Faculty of Science & Technology, Universiti Kebangsaan MalaysiaDepartment of Chemical Sciences, Faculty of Science & Technology, Universiti Kebangsaan MalaysiaDepartment of Electrical, Electronic & Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan MalaysiaUKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical CentreAbstract Early bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA) and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89–0.97]; Sn 80% [95% CI: 72–87]; Sp 94% [95% CI: 81–89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88–0.97]; Sn 75% [95% CI: 66–83]; Sp 91 [95% CI: 77–98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC.https://doi.org/10.1038/s41598-021-90894-0 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Toh Leong Tan Christabel Wan-li Kang Kai Shen Ooi Swee Thian Tan Nurul Saadah Ahmad Dian Nasriana Nasuruddin Azlin Ithnin Khaizurin Tajul Arifin Lee Yook Heng Nurul Izzaty Hassan Kok Beng Gan Hui-min Neoh |
spellingShingle |
Toh Leong Tan Christabel Wan-li Kang Kai Shen Ooi Swee Thian Tan Nurul Saadah Ahmad Dian Nasriana Nasuruddin Azlin Ithnin Khaizurin Tajul Arifin Lee Yook Heng Nurul Izzaty Hassan Kok Beng Gan Hui-min Neoh Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection Scientific Reports |
author_facet |
Toh Leong Tan Christabel Wan-li Kang Kai Shen Ooi Swee Thian Tan Nurul Saadah Ahmad Dian Nasriana Nasuruddin Azlin Ithnin Khaizurin Tajul Arifin Lee Yook Heng Nurul Izzaty Hassan Kok Beng Gan Hui-min Neoh |
author_sort |
Toh Leong Tan |
title |
Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection |
title_short |
Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection |
title_full |
Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection |
title_fullStr |
Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection |
title_full_unstemmed |
Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection |
title_sort |
comparison of spla2iia performance with high-sensitive crp neutrophil percentage pct and lactate to identify bacterial infection |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-05-01 |
description |
Abstract Early bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA) and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89–0.97]; Sn 80% [95% CI: 72–87]; Sp 94% [95% CI: 81–89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88–0.97]; Sn 75% [95% CI: 66–83]; Sp 91 [95% CI: 77–98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC. |
url |
https://doi.org/10.1038/s41598-021-90894-0 |
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