The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants

José Luis Leante-Castellanos; Luis García de Guadiana-Romualdo; Carmen Fuentes-Gutiérrez; Ana Hernando-Holgado; Ana García-González; Enrique Jiménez-Santos

doi:10.1515/jpm-2014-0010

Article

The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants

José Luis Leante-Castellanos , Luis García de Guadiana-Romualdo , Carmen Fuentes-Gutiérrez , Ana Hernando-Holgado , Ana García-González and Enrique Jiménez-Santos

Published/Copyright: July 11, 2014

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From the journal Journal of Perinatal Medicine Volume 43 Issue 2

Abstract

Objective: To assess the accuracy of lipopolysaccharide binding protein (LBP) for diagnosing late-onset neonatal sepsis (LONS) in very low birth weight (VLBW) infants.

Study design: Observational, prospective study. We assessed the diagnostic performance of LBP in 26 suspected LONS episodes among 54 patients. Proven and probable LONS episodes were recorded according to established criteria. Receiver operating characteristic curve analysis was performed to evaluate LBP’s ability to predict LONS.

Results: LONS was diagnosed in 17 of 26 episodes. LBP levels were significantly higher in confirmed LONS episodes (P<0.001). The area under the curve of LBP was 0.89. A cut-off of 17.5 μg/mL had a sensitivity of 94.1%, a specificity of 77.8%, a positive predictive value of 88.9% and a negative predictive value of 87.5%.

Conclusions: Serum LBP measurement may be useful as an additional tool in the evaluation of suspected LONS in VLBW infants.

Keywords: Infant/premature; infection/diagnosis; prospective studies; sepsis/diagnosis

Corresponding author: José Luis Leante-Castellanos, Neonatology Unit, Hospital General Universitario Santa Lucía, C/ Mezquita – Paraje Los Arcos, E-30202 Santa Lucía, Cartagena, Spain, Tel.: +34 968128600, Fax: +34 968128646, E-mail: leantejl@yahoo.es

Acknowledgments

We thank the staff of the Neonatology Unit and the Biochemistry Department of Hospital General Universitario Santa Lucía for their contribution to this study.

References

[1] Behrendt D, Dembinski J, Heep A, Bartmann P. Lipopolysaccharide binding protein in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2004;89:F551–4.10.1136/adc.2003.030049Search in Google Scholar

[2] Bentlin MR, de Souza Rugolo LM. Late-onset sepsis: epidemiology, evaluation, and outcome. NeoReviews. 2010;11:e426–35.10.1542/neo.11-8-e426Search in Google Scholar

[3] Berner R, Fürll B, Stelter F, Dröse J, Müller H-P, Schütt C. Elevated levels of lipopolysaccharide-binding protein and soluble CD14 in plasma in neonatal early-onset sepsis. Clin Diagn Lab Immunol. 2002;9:440–5.10.1128/CDLI.9.2.440-445.2002Search in Google Scholar

[4] Caldas JP, Marba S, Blotta MHS, Calil R, Morais SS, Oliveira RT. Accuracy of white blood cell count, C-reactive protein, interleukin-6 and tumor necrosis factor alpha for diagnosing late neonatal sepsis. J Pediatr (Rio J). 2008;84:536–42.10.1590/S0021-75572008000700011Search in Google Scholar

[5] De Man P, Verhoeven BAN, Verbrugh HA, Vos MC, Van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet. 2000;355:973–8.10.1016/S0140-6736(00)90015-1Search in Google Scholar

[6] Delsesto D, Opal SM. Future perspectives on regulating pro-and antiinflammatory responses in sepsis. Contrib Microbiol. 2011;17:137–56.10.1159/000324030Search in Google Scholar PubMed

[7] Fanaroff AA, Korones SB, Wright LL, Verter J, Poland RL, Bauer CR, et al. Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. Pediatr Infect Dis J. 1998;17:593.10.1097/00006454-199807000-00004Search in Google Scholar PubMed

[8] Griffin MP, Lake DE, Bissonette EA, Harrell FE, O’Shea TM, Moorman JR. Heart rate characteristics: novel physiomarkers to predict neonatal infection and death. Pediatrics. 2005;116:1070–4.10.1542/peds.2004-2461Search in Google Scholar PubMed

[9] Hemming VG, Overall Jr JC, Britt MR. Nosocomial infections in a newborn intensive-care unit. N Engl J Med. 1976;294:1310–16.10.1056/NEJM197606102942403Search in Google Scholar PubMed

[10] Leante-Castellanos JL, Lloreda-García JM, García-González A, Llopis-Baño C, Fuentes-Gutiérrez C, Alonso-Gallego JA, et al. Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants. J Perinat Med. 2012;40:571–6.10.1515/jpm-2011-0269Search in Google Scholar PubMed

[11] López SJB, Coto CD, Fernández CB, Grupo de Hospitales Castrillo. Neonatal sepsis of nosocomial origin: an epidemiological study from the “Grupo de Hospitales Castrillo”. J Perinat Med. 2002;30:149–57.Search in Google Scholar

[12] Pavcnik-Arnol M, Hojker S, Derganc M. Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein. Intensive Care Med. 2004;30:1454–60.10.1007/s00134-004-2307-4Search in Google Scholar PubMed

[13] Pavcnik-Arnol M, Hojker S, Derganc M. Lipopolysaccharide-binding protein, lipopolysaccharide, and soluble CD14 in sepsis of critically ill neonates and children. Intensive Care Med. 2007;33:1025–32.10.1007/s00134-007-0626-ySearch in Google Scholar PubMed

[14] Report on the Expert Meeting on Neonatal and Paediatric Sepsis, EMA Report, London, June 8, 2010. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Report/2010/12/WC500100199.pdf. Accessed 8 March 2011. Search in Google Scholar

[15] Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110:285–91.10.1542/peds.110.2.285Search in Google Scholar PubMed

[16] Vouloumanou EK, Plessa E, Karageorgopoulos DE, Mantadakis E, Falagas ME. Serum procalcitonin as a diagnostic marker for neonatal sepsis: a systematic review and meta-analysis. Intensive Care Med. 2011;37:747–62.10.1007/s00134-011-2174-8Search in Google Scholar PubMed

[17] Weitkamp JH, Aschner JL. Diagnostic use of C-reactive protein (CRP) in assessment of neonatal sepsis. NeoReviews. 2005;6:e508–15.10.1542/neo.6-11-e508Search in Google Scholar

[18] Zweigner J, Schumann RR, Weber JR. The role of lipopolysaccharide-binding protein in modulating the innate immune response. Microbes Infect. 2006;8:946–52.10.1016/j.micinf.2005.10.006Search in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Article note

Presented at the “XXIV Congreso de Neonatología y Medicina Perinatal”, Sociedad Española de Neonatología, Barcelona, Spain, October 2–4, 2013.

Received: 2014-1-7

Accepted: 2014-6-11

Published Online: 2014-7-11

Published in Print: 2015-3-1

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Articles in the same Issue

https://doi.org/10.1515/jpm-2014-0010

Keywords for this article

Infant/premature; infection/diagnosis; prospective studies; sepsis/diagnosis