Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Biomedicines Année : 2023

Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study

Sylvie Pons
Sophie Trouillet-Assant
  • Fonction : Auteur
Fatima Abbas-Chorfa
  • Fonction : Auteur
Elise Cornaton
  • Fonction : Auteur
Amélie Berthiot
  • Fonction : Auteur
Sonia Galletti
  • Fonction : Auteur
Aurélie Plat
  • Fonction : Auteur
Stephanie Rapin
  • Fonction : Auteur
Laurene Trapes
  • Fonction : Auteur
Laurence Generenaz
  • Fonction : Auteur
Karen Brengel-Pesce
Arnaud Callies
Franck Plaisant
  • Fonction : Auteur
Olivier Claris
  • Fonction : Auteur
Aurelie Portefaix
  • Fonction : Auteur
Marine Butin
  • Fonction : Auteur
  • PersonId : 1079314

Résumé

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.

Dates et versions

hal-04179297 , version 1 (09-08-2023)

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Citer

Sylvie Pons, Sophie Trouillet-Assant, Fabien Subtil, Fatima Abbas-Chorfa, Elise Cornaton, et al.. Performance of 11 Host Biomarkers Alone or in Combination in the Diagnosis of Late-Onset Sepsis in Hospitalized Neonates: The Prospective EMERAUDE Study. Biomedicines, 2023, 11 (6), pp.1703. ⟨10.3390/biomedicines11061703⟩. ⟨hal-04179297⟩
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