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Serum amyloid A – A prime candidate for identification of neonatal sepsis
Paediatric Clinic, Ryhov County Hospital, Jönköping, Region Jönköping County, Sweden.
Department of Laboratory Medicine, Jönköping, Region Jönköping County, Sweden.
Paediatric Clinic, Ryhov County Hospital, Jönköping, Region Jönköping County, Sweden.
Virtual Engineering Research Environment, School of Engineering Science, University of Skövde, Skövde, Sweden.ORCID iD: 0000-0003-0899-8939
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2021 (English)In: Clinical Immunology, ISSN 1521-6616, E-ISSN 1521-7035, Vol. 229, article id 108787Article in journal (Refereed) Published
Abstract [en]

Neonatal sepsis is common, lethal, and hard to diagnose. In combination with clinical findings and blood culture, biomarkers are crucial to make the correct diagnose. A Swedish national inquiry indicated that neonatologists were not quite satisfied with the available biomarkers. We assessed the kinetics of 15 biomarkers simultaneously: ferritin, fibrinogen, granulocyte colony-stimulating factor (G-CSF), interferon (IFN)-γ, interleukin (IL)-1β, −6, −8, −10, macrophage inflammatory protein (MIP)-1β, procalcitonin, resistin, serum amyloid A (SAA), tumor necrosis factor (TNF)-α, tissue plasminogen activator-3 and visfatin. The goal was to observe how quickly they rise in response to infection, and for how long they remain elevated. From a neonatal intensive care unit, newborns ≥28 weeks gestational age were recruited. Sixty-eight newborns were recruited to the study group (SG), and fifty-one to the control group (CG). The study group subjects were divided into three subgroups depending on clinical findings: confirmed sepsis (CSG), suspected sepsis (SSG) and no sepsis. CSG and SSG were also merged into an entire sepsis group (ESG) for sub-analysis. Blood samples were collected at three time-points; 0 h, 12–24 h and 48–72 h, in order to mimic a “clinical setting”. At 0 h, visfatin was elevated in SSG compared to CG; G-CSF, IFN-γ, IL-1β, −8 and − 10 were elevated in SSG and ESG compared to CG, whereas IL-6 and SAA were elevated in all groups compared to CG. At 12–24 h, IL-8 was elevated in ESG compared to CG, visfatin was elevated in ESG and SSG compared to CG, and SAA was elevated in all three groups compared to CG. At 48–72 h, fibrinogen was elevated in ESG compared to CG, IFN-γ and IL-1β were elevated in SSG and ESG compared to CG, whereas IL-8 and SAA were elevated in all three groups compared to CG. A function of time-formula is introduced as a tool for theoretical prediction of biomarker levels at any time-point. We conclude that SAA has the most favorable kinetics regarding diagnosing neonatal sepsis, of the biomarkers studied. It is also readily available methodologically, making it a prime candidate for clinical use.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 229, article id 108787
Keywords [en]
Biomarkers, Function of time, Kinetics, Neonatal, Sepsis, Serum amyloid A
National Category
Immunology in the medical area
Identifiers
URN: urn:nbn:se:hj:diva-54114DOI: 10.1016/j.clim.2021.108787ISI: 000678442400003PubMedID: 34175457Scopus ID: 2-s2.0-85109082881Local ID: HOA;;1580931OAI: oai:DiVA.org:hj-54114DiVA, id: diva2:1580931
Available from: 2021-07-17 Created: 2021-07-17 Last updated: 2024-01-19Bibliographically approved

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Salomonsson, KentFaresjö, Maria

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