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Diagnostic utility of elevated serum soluble triggering receptor expressed on myeloid cells (sTREM)-1 in infected neonates

Kosmas Sarafidis| Vasiliki Soubasi-Griva| Kaliopi Piretzi| Agathi Thomaidou| Eleni Agakidou| Anna Taparkou| Elisavet Diamanti| Vasiliki Drossou-Agakidou
Pediatric Brief Report
Volume 36, Issue 5 / May , 2010

Pages 864 - 868

Abstract

Objective

To assess the value of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for early diagnosis of late-onset sepsis (LOS) in neonates, compared with interleukin-6 (IL-6).

Design and setting

Prospective, observational study in a single, level III neonatal intensive care unit of a university hospital.

Patients

Fifty-two preterm and term neonates evaluated for suspected LOS were studied. Neonates were classified into two groups: infected [confirmed sepsis (n = 22) and possible sepsis (n = 9)] and noninfected neonates (n = 21).

Measurements and results

Serum sTREM-1 and IL-6 were measured (enzyme-linked immunosorbent assays) when signs suggestive of sepsis emerged. Infected neonates had significantly higher sTREM-1 (p = 0.004) and IL-6 (p < 0.0001) than noninfected neonates. Receiver operating characteristic (ROC) curve analysis resulted in significant areas under the curve (AUC) for both sTREM-1 (AUC = 0.733, p = 0.005) and IL-6 (AUC = 0.892, p = 0.001) for identification of infected neonates, with the difference between the two AUC not being significant. Further analysis documented acceptable diagnostic performance of sTREM-1 and IL-6, which was not improved, however, when the two markers were combined.

Conclusions

Serum sTREM-1 increases in infected neonates. Diagnostic accuracy of sTREM-1 either alone or in combination with IL-6 is not better than that of IL-6.

Keywords

SepsisBiomarkersPretermTermNeonate

References

  1. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W, Bauer CR, Korones SB, Shankaran S, Laptook AR, Stevenson DK, Papile LA, Poole WK (2002) Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 110:285–291
    • View reference on publisher's website
    • View reference on PubMed
  2. Kermorvant-Duchemin E, Laborie S, Rabilloud M, Lapillonne A, Claris O (2008) Outcome and prognostic factors in neonates with septic shock. Pediatr Crit Care Med 9:186–191
    • View reference on publisher's website
    • View reference on PubMed
  3. Carrigan SD, Scott G, Tabrizian M (2004) Toward resolving the challenges of sepsis diagnosis. Clin Chem 50:1301–1314
    • View reference on publisher's website
    • View reference on PubMed
  4. Bouchon A, Dietrich J, Colonna M (2000) Cutting edge: inflammatory responses can be triggered by TREM-1, a novel receptor expressed on neutrophils and monocytes. J Immunol 164:4991–4995
    • View reference on PubMed
  5. Knapp S, Gibot S, de Vos A, Versteeg HH, Colonna M, van der Poll T (2004) Cutting edge: expression patterns of surface and soluble triggering receptor expressed on myeloid cells-1 in human endotoxemia. J Immunol 173:7131–7134
    • View reference on PubMed
  6. Gibot S, Kolopp-Sarda MN, Béné MC, Cravoisy A, Levy B, Faure GC, Bollaert PE (2004) Plasma level of a triggering receptor expressed on myeloid cells-1: its diagnostic accuracy in patients with suspected sepsis. Ann Intern Med 141:9–15
    • View reference on PubMed
  7. Müller B, Gencay MM, Gibot S, Stolz D, Hunziker L, Tamm M, Christ-Crain M (2007) Circulating levels of soluble triggering receptor expressed on myeloid cells (sTREM)-1 in community-acquired pneumonia. Crit Care Med 35:990–991
    • View reference on publisher's website
    • View reference on PubMed
  8. Gibot S, Cravoisy A, Levy B, Bene MC, Faure G, Bollaert PE (2004) Soluble triggering receptor expressed on myeloid cells and the diagnosis of pneumonia. N Engl J Med 350:451–458
    • View reference on publisher's website
    • View reference on PubMed
  9. Determann RM, Weisfelt M, de Gans J, van der Ende A, Schultz MJ, van de Beek D (2006) Soluble triggering receptor expressed on myeloid cells 1: a biomarker for bacterial meningitis. Intensive Care Med 32:1243–1247
  10. Ng PC, Cheng SH, Chui KM, Fok TF, Wong MY, Wong W, Wong RP, Cheung KL (1997) Diagnosis of late onset neonatal sepsis with cytokines, adhesion molecule, and C-reactive protein in preterm very low birth weight infants. Arch Dis Child Fetal Neonatal Ed 77:F221–F227
    • View reference on publisher's website
    • View reference on PubMed
  11. Verboon-Maciolek MA, Thijsen SF, Hemels MA, Menses M, van Loon AM, Krediet TG, Gerards LJ, Fleer A, Voorbij HA, Rijkers GT (2006) Inflammatory mediators for the diagnosis and treatment of sepsis in early infancy. Pediatr Res 59:457–461
    • View reference on publisher's website
    • View reference on PubMed
  12. Adib-Conquy M, Monchi M, Goulenok C, Laurent I, Thuong M, Cavaillon JM, Adrie C (2007) Increased plasma levels of soluble triggering receptor expressed on myeloid cells 1 and procalcitonin after cardiac surgery and cardiac arrest without infection. Shock 28:406–410
    • View reference on publisher's website
    • View reference on PubMed
  13. Jiyong J, Tiancha H, Wei C, Huahao S (2009) Diagnostic value of the soluble triggering receptor expressed on myeloid cells-1 in bacterial infection: a meta-analysis. Intensive Care Med 35:587–595
  14. Chen HL, Hung CH, Tseng HI, Yang RC (2008) Soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1) as a diagnostic marker of serious bacterial infection in febrile infants less than three months of age. Jpn J Infect Dis 61:31–35
    • View reference on PubMed
  15. Giamarellos-Bourboulis EJ, Zakynthinos S, Baziaka F, Papadomichelakis E, Virtzili S, Koutoukas P, Armaganidis A, Giamarellou H, Roussos C (2006) Soluble triggering receptor expressed on myeloid cells 1 as an anti-inflammatory mediator in sepsis. Intensive Care Med 32:237–243
  16. Akobeng AK (2007) Understanding diagnostic tests 1: sensitivity, specificity and predictive values. Acta Paediatr 96:338–341
    • View reference on publisher's website
    • View reference on PubMed
  17. Haque KN (2005) Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med 6(3 Suppl):S45–S49
    • View reference on publisher's website
    • View reference on PubMed
  18. Reier-Nilsen T, Farstad T, Nakstad B, Lauvrak V, Steinbakk M (2009) Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study. BMC Pediatr 9:5
    • View reference on publisher's website
    • View reference on PubMed

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