Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study
Background and Objectives: The transmembrane glycoprotein TREM-1 triggers an inflammatory response. Its soluble fraction (sTREM-1) has been shown to have diagnostic accuracy for late-onset neonatal sepsis (LONS). Until now, the potential of sTREM-1 to predict septic shock and/or death in septic neon...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Elsevier
2015-01-01
|
Series: | International Journal of Infectious Diseases |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971214016658 |
id |
doaj-d0b05a5742a5487a9b1fb06bc46d68f0 |
---|---|
record_format |
Article |
spelling |
doaj-d0b05a5742a5487a9b1fb06bc46d68f02020-11-24T21:18:29ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112015-01-0130C273210.1016/j.ijid.2014.10.013Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot studyVíctor Arízaga-Ballesteros0Mario René Alcorta-García1Lizzeth Carolina Lázaro-Martínez2Jesús Manuel Amézquita-Gómez3José Manuel Alanís-Cajero4Luis Villela5Fabiola Castorena-Torres6Víctor Javier Lara-Díaz7Tecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaTecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaTecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaTecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaTecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaTecnológico de Monterrey, Escuela de Medicina, Dirección de Investigación e InnovaciónTecnológico de Monterrey, Escuela de Medicina, Dirección de Investigación e InnovaciónTecnológico de Monterrey, Escuela de Medicina. Programa Multicéntrico de Residencias Médicas, NeonatologíaBackground and Objectives: The transmembrane glycoprotein TREM-1 triggers an inflammatory response. Its soluble fraction (sTREM-1) has been shown to have diagnostic accuracy for late-onset neonatal sepsis (LONS). Until now, the potential of sTREM-1 to predict septic shock and/or death in septic neonates has not been explored. This study obtained estimates of the incidence and prevalence of septic shock and/or death in septic neonates for future sample size calculations for confirmatory studies and evaluated the feasibility of using sTREM-1 as a predictor of septic shock and/or death in neonates with LONS criteria. Study design: A pilot study with a cross-sectional design was performed from May 1st to October 31st, 2012. The participants were hospitalized neonates who, after three days of life, were diagnosed as having LONS. Plasma sTREM-1 was quantified by ELISA. The main outcome measurement was the development of septic shock and/or death. Results: Of 71 eligible subjects, nine (12.7%) progressed to septic shock and/or death. In the LONS-Non-Shock group, the sTREM-1 median and interquartile range (IQR) plasma value were 10 (10 to 70) pg/mL. In the LONS & Shock/Death group, the values were 567 (260 to 649) pg/mL. These values were significantly different (Mann-Whitney’s U test, p = 0.001). A ROC curve for a proposed sTREM-1 cut-off value of 300 pg/mL exhibited an area under the curve of 0.884 (95% CI = 0.73 to 1.0; p < 0.0001), with a sensitivity of 0.78 (95% CI = 0.46 to 0.94) and specificity of 0.97 (95% CI = 0.92 to 0.99); PPV would be 0.78 (95% CI = 0.46 to 0.94) and NPV 0.97 (95% CI = 0.92 to 0.99). Conclusions: In neonates with LONS, sTREM-1 has the potential to provide an excellent predictive value for septic shock/death. Larger sample sizes are needed to identify the optimal cut-off value of plasma sTREM-1 for this diagnosis and to provide diagnostic accuracy measures.http://www.sciencedirect.com/science/article/pii/S1201971214016658PrematureDiseasesIntensive careNeonatalSepsisDiagnosisROC curveSensitivity and Specificity. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Víctor Arízaga-Ballesteros Mario René Alcorta-García Lizzeth Carolina Lázaro-Martínez Jesús Manuel Amézquita-Gómez José Manuel Alanís-Cajero Luis Villela Fabiola Castorena-Torres Víctor Javier Lara-Díaz |
spellingShingle |
Víctor Arízaga-Ballesteros Mario René Alcorta-García Lizzeth Carolina Lázaro-Martínez Jesús Manuel Amézquita-Gómez José Manuel Alanís-Cajero Luis Villela Fabiola Castorena-Torres Víctor Javier Lara-Díaz Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study International Journal of Infectious Diseases Premature Diseases Intensive care Neonatal Sepsis Diagnosis ROC curve Sensitivity and Specificity. |
author_facet |
Víctor Arízaga-Ballesteros Mario René Alcorta-García Lizzeth Carolina Lázaro-Martínez Jesús Manuel Amézquita-Gómez José Manuel Alanís-Cajero Luis Villela Fabiola Castorena-Torres Víctor Javier Lara-Díaz |
author_sort |
Víctor Arízaga-Ballesteros |
title |
Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study |
title_short |
Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study |
title_full |
Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study |
title_fullStr |
Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study |
title_full_unstemmed |
Can sTREM-1 predict septic shock & death in late-onset neonatal sepsis? A pilot study |
title_sort |
can strem-1 predict septic shock & death in late-onset neonatal sepsis? a pilot study |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 1878-3511 |
publishDate |
2015-01-01 |
description |
Background and Objectives: The transmembrane glycoprotein TREM-1 triggers an inflammatory response. Its soluble fraction (sTREM-1) has been shown to have diagnostic accuracy for late-onset neonatal sepsis (LONS). Until now, the potential of sTREM-1 to predict septic shock and/or death in septic neonates has not been explored. This study obtained estimates of the incidence and prevalence of septic shock and/or death in septic neonates for future sample size calculations for confirmatory studies and evaluated the feasibility of using sTREM-1 as a predictor of septic shock and/or death in neonates with LONS criteria.
Study design: A pilot study with a cross-sectional design was performed from May 1st to October 31st, 2012. The participants were hospitalized neonates who, after three days of life, were diagnosed as having LONS. Plasma sTREM-1 was quantified by ELISA. The main outcome measurement was the development of septic shock and/or death.
Results: Of 71 eligible subjects, nine (12.7%) progressed to septic shock and/or death. In the LONS-Non-Shock group, the sTREM-1 median and interquartile range (IQR) plasma value were 10 (10 to 70) pg/mL. In the LONS & Shock/Death group, the values were 567 (260 to 649) pg/mL. These values were significantly different (Mann-Whitney’s U test, p = 0.001).
A ROC curve for a proposed sTREM-1 cut-off value of 300 pg/mL exhibited an area under the curve of 0.884 (95% CI = 0.73 to 1.0; p < 0.0001), with a sensitivity of 0.78 (95% CI = 0.46 to 0.94) and specificity of 0.97 (95% CI = 0.92 to 0.99); PPV would be 0.78 (95% CI = 0.46 to 0.94) and NPV 0.97 (95% CI = 0.92 to 0.99).
Conclusions: In neonates with LONS, sTREM-1 has the potential to provide an excellent predictive value for septic shock/death. Larger sample sizes are needed to identify the optimal cut-off value of plasma sTREM-1 for this diagnosis and to provide diagnostic accuracy measures. |
topic |
Premature Diseases Intensive care Neonatal Sepsis Diagnosis ROC curve Sensitivity and Specificity. |
url |
http://www.sciencedirect.com/science/article/pii/S1201971214016658 |
work_keys_str_mv |
AT victorarizagaballesteros canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT mariorenealcortagarcia canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT lizzethcarolinalazaromartinez canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT jesusmanuelamezquitagomez canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT josemanuelalaniscajero canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT luisvillela canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT fabiolacastorenatorres canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy AT victorjavierlaradiaz canstrem1predictsepticshockdeathinlateonsetneonatalsepsisapilotstudy |
_version_ |
1726009018120404992 |