scholarly journals Lipocalin-2 is a Sensitive and Specific Marker of Bacterial Infection in Children

2019 ◽  
Author(s):  
Jethro Herberg ◽  
Honglei Huang ◽  
Marie L. Thezenas ◽  
Victoria Janes ◽  
Michael Carter ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Clinical Management ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Antimicrobial Treatment ◽  
Specific Marker ◽  
Lipocalin 2 ◽  
Reactive Protein ◽  
Neutrophil Collagenase ◽  
Clinical Algorithms

AbstractIntroductionBacterial infection is the leading cause of death in children globally. Clinical algorithms to identify children who are likely to benefit from antimicrobial treatment remain suboptimal. Biomarkers that accurately identify serious bacterial infection (SBI) could improve diagnosis and clinical management. Lipocalin 2 (LCN2) and neutrophil collagenase (MMP-8) are neutrophil-derived biomarkers associated with bacterial infection.MethodsWe evaluated LCN2 and MMP-8 as candidate biomarkers in 40 healthy controls and 151 febrile children categorised confirmed SBI, probable SBI, or viral infection. The diagnostic performance of LCN2 and MMP-8 to predict SBI was estimated by the area under the receiver operating characteristic curve (AUROC) and compared to the performance of C-reactive protein (CRP).ResultsPlasma LCN2 and MMP-8 concentration were predictive of SBI. The AUROC (95% CI) for LCN2, MMP8 and CRP to predict SBI was 0.88 (0.82-0.94); 0.80 (0.72-0.87) and 0.89 (0.84-0.94), respectively. The diagnostic performance of LCN2 in combination with CRP was significantly superior to either marker alone: AUROC 0.92 (95% CI: 0.88-0.96).ConclusionLCN2 is a sensitive and specific predictor of SBI in children which could be used to improve clinical management and antimicrobial stewardship. LCN2 should be further evaluated in prospective clinical studies.

scholarly journals Comparison of sPLA2IIA performance with high-sensitive CRP neutrophil percentage PCT and lactate to identify bacterial infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toh Leong Tan ◽  
Christabel Wan-li Kang ◽  
Kai Shen Ooi ◽  
Swee Thian Tan ◽  
Nurul Saadah Ahmad ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Serum Levels ◽  
C Reactive Protein ◽  
Middle Income ◽  
Antibiotic Overuse ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Patient Arrival

AbstractEarly bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA) and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89–0.97]; Sn 80% [95% CI: 72–87]; Sp 94% [95% CI: 81–89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88–0.97]; Sn 75% [95% CI: 66–83]; Sp 91 [95% CI: 77–98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC.

scholarly journals COMPARISON OF sPLA2-IIA PERFORMANCE WITH HIGH-SENSITIVE CRP, NEUTROPHIL PERCENTAGE, PCT AND LACTATE TO IDENTIFY BACTERIAL INFECTION: A PROSPECTIVE STUDY

2021 ◽  
Author(s):  
Toh Leong Tan ◽  
Christabel Wan-li Kang ◽  
Kai Shen Ooi ◽  
Swee Thian Tan ◽  
Nurul Saadah Ahmad ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Serum Levels ◽  
Middle Income ◽  
Antibiotic Overuse ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Patient Arrival ◽  
A Prospective Study

ABSTRACTEarly bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA), and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89-0.97]; Sn 80% [95% CI: 72-87] Sp 94% [95% CI: 81-89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88-0.97]; Sn 75% [95% CI: 66-83]; Sp 91 [95% CI: 77-98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC.

scholarly journals Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Seung Ji Kang ◽  
Uh Jin Kim ◽  
Seong Eun Kim ◽  
Joon Hwan An ◽  
Mi Ok Jang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Bacterial Infection ◽  
Transarterial Chemoembolization ◽  
Prospective Observational Study ◽  
Characteristic Curve ◽  
Antibiotic Use ◽  
Reactive Protein ◽  
Empirical Antibiotics

This prospective observational study aimed at investigating the role of procalcitonin (PCT) in diagnosing bacterial infection and guiding antibiotic therapy for hepatocellular carcinoma (HCC) patients with fever after transarterial chemoembolization (TACE) and/or radiofrequency ablation (RFA). Ninety-seven cases (84 patients) were enrolled. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) counts were measured on the day of fever onset (day 0) and days 1, 3, 5, and 7 of fever. Empirical antibiotics were initiated only if PCT was ≥0.5 ng/mL or specific infection foci were suspected. An infectious cause was found in nine cases. PCT on day 0 of fever was significantly higher in patients with bacterial infection than in those without infection (P=0.035). The area under the receiver operating characteristic curve for PCT was 0.715 (95% confidence interval, 0.538–0.892) and was higher than that for CRP (0.598 (0.368–0.828)) or WBC counts (0.502 (0.307–0.697)). In patients undergoing TACE and/or RFA, a significantly lower number of antibiotics were prescribed during the study period than during the prestudy period (P<0.001). In conclusion, PCT might be a biomarker for diagnosing infection and guiding antibiotic treatment to reduce unnecessary antibiotic use in patients with fever after TACE and/or RFA.

scholarly journals Serum procacitonin as a diagnostic marker of bacterial infection in febrile children

2017 ◽  
Vol 4 (4) ◽  
pp. 1381
Author(s):  
Brindha K. ◽  
Kumar Manickam ◽  
Santhakumari Ulagaratchagan ◽  
Mohan Kumar ◽  
Sowmya Sampath ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Bacterial Infections ◽  
Operating Characteristic ◽  
Diagnostic Marker ◽  
Characteristic Curve ◽  
Reactive Protein ◽  
Highly Sensitive ◽  
Hs Crp ◽  
Better Than

Background: Early and accurate diagnosis of bacterial infections in children is important as the outcome is dependent on it. Various tests and biomarkers have been used for this among which serum procalcitonin shows a lot of promise. The aim of the study was to determine the role of serum procalcitonin as a diagnostic marker of bacterial infection in febrile children.Methods: All acutely febrile children between 6 months to 12 years of age were enrolled in this prospective study. The efficacy of procalcitonin (PCT), highly sensitive C-reactive protein (hs CRP) and absolute neutrophil count (ANC) in diagnosing bacterial infections was compared.Results: Among the three parameters, PCT has the highest area under the receiver operating characteristic curve (AUC) (O.755), followed by CRP (AUC 0.717) and ANC (AUC 0.628).Conclusions: In summary, our study showed that PCT performs better than hs CRP and ANC in detecting bacterial infection in febrile children. 

scholarly journals C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

2020 ◽  
Author(s):  
Wei Feng ◽  
Qian-Yu Yang ◽  
Xu-Feng Zhao ◽  
Miao-Miao Li ◽  
Hua-Lei Cui
Keyword(s):  
Characteristic Curve ◽  
Prognostic Score ◽  
Area Under The Curve ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

The use of the ratio of C-reactive protein to albumin for the diagnosis of complicated appendicitis in children

2020 ◽  
Author(s):  
Wei Feng ◽  
Qian-Yu Yang ◽  
Xu-Feng Zhao ◽  
Miao-Miao Li ◽  
Hua-Lei Cui
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Prognostic Score ◽  
Area Under The Curve ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. The ratio of serum C-reactive protein (CRP) to albumin (ALB) (CRP/ALB ratio) is a new inflammation-based prognostic score that is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of the CRP/ALB ratio for the diagnosis of complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessments of age, sex, symptom duration, albumin and routine blood indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into a simple appendicitis group (127 patients) and a complicated appendicitis group (105 patients). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis than in simple appendicitis (p<0.05). Logistic regression analysis showed that higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of the CRP/ALB ratio (0.946) was larger than that of MC (0.619), CRP (0.906) and PCT (0.843). A CRP/ALB ratio >1.43 was found to be a significant marker in the prediction of complicated appendicitis, with 91.4% sensitivity and 90.6% specificity. Patients with a CRP/ALB ratio >1.43 had a 102.22 times higher chance of having complicated appendicitis (95% CI: 41.322 - 252.874) than those with a CRP/ALB ratio ≤1.43. Conclusion: The admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. The CRP/ALB ratio is a novel but promising haematological marker that aids in the differentiation of acute complicated and simple appendicitis.

Diagnostic performance of serum high-sensitivity procalcitonin and serum C-reactive protein tests for detecting bacterial infection in febrile neutropenia

Infection ◽  
2014 ◽  
Vol 42 (6) ◽  
pp. 971-979 ◽  
Author(s):  
Mizuki Aimoto ◽  
Hideo Koh ◽  
Takako Katayama ◽  
Hiroshi Okamura ◽  
Takuro Yoshimura ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Bacterial Infection ◽  
Diagnostic Performance ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Procalcitonin Is a Specific Marker for Detecting Bacterial Infection in Patients with Rheumatoid Arthritis

2012 ◽  
Vol 39 (8) ◽  
pp. 1517-1523 ◽  
Author(s):  
HIROE SATO ◽  
NAOHITO TANABE ◽  
AKIRA MURASAWA ◽  
YASUHIRO OTAKI ◽  
TAKEHITO SAKAI ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bacterial Infection ◽  
Positive Likelihood Ratio ◽  
Chronic Inflammatory Disease ◽  
Specific Marker ◽  
Reactive Protein ◽  
Serious Infections ◽  
Significant Difference ◽  
The Difference ◽  
Wbc Count

Objective.Rheumatoid arthritis (RA) is a chronic inflammatory disease accompanied by many complications, and serious infections are associated with many of the advanced therapeutics used to treat it. We assessed serum procalcitonin (PCT) levels to distinguish bacterial infection from other complications in patients with RA.Methods.One hundred eighteen patients experiencing an RA flare, noninfectious complication of RA or its treatment, nonbacterial infection, or bacterial infection were studied. Serum PCT concentrations were determined with a chemiluminescent enzyme immunoassay.Results.All patients experiencing an RA flare showed negative PCT levels (≤ 0.1 ng/ml; n = 18). The PCT level was higher in the bacterial infection group (25.8% had levels ≥ 0.5 ng/ml) than in the other 3 groups (0.0–4.3% had levels ≥ 0.5 ng/ml) and the difference was significant among groups (p = 0.003). Conversely, no statistically significant difference was observed among the groups with C-reactive protein (CRP) concentration ≥ 0.3 mg/dl (p = 0.513), white blood cell (WBC) count > 8500/mm3 (p = 0.053), or erythrocyte sedimentation rate (ESR) > 15 mm/h (p = 0.328). The OR of high PCT level (≥ 0.5 ng/ml) for detection of bacterial infection was 19.13 (95% CI 2.44–149.78, p = 0.005). Specificity and positive likelihood ratio of PCT ≥ 0.5 ng/ml were highest (98.2% and 14.33, respectively) for detection of bacterial infection, although the sensitivity was low (25.8%).Conclusion.Serum PCT level is a more specific marker for detection of bacterial infection than either CRP, ESR, or WBC count in patients with RA. High PCT levels (≥ 0.5 ng/ml) strongly suggest bacterial infection. However, PCT < 0.5 ng/ml, even if < 0.2 ng/ml, does not rule out bacterial infection and physicians should treat appropriately.

Clinical Application of Computer-Aided Diagnosis According to S-Detect in Category 4 Breast Lesions: Prospective Single-Center Study (Preprint)

2020 ◽  
Author(s):  
Pengfei Sun ◽  
Chen Chen ◽  
Weiqi Wang ◽  
Lei Liang ◽  
Dan Luo ◽  
...  
Keyword(s):  
Clinical Management ◽  
Diagnostic Performance ◽  
Breast Biopsy ◽  
Computer Aided Diagnosis ◽  
Breast Lesions ◽  
Breast Masses ◽  
Computer Aided ◽  
Conventional Ultrasound ◽  
Us Findings ◽  
Aided Diagnosis

BACKGROUND Computer-aided diagnosis (CAD) is a useful tool that can provide a reference for the differential diagnosis of benign and malignant breast lesion. Previous studies have demonstrated that CAD can improve the diagnostic performance. However, conventional ultrasound (US) combined with CAD were used to adjust the classification of category 4 lesions has been few assessed. OBJECTIVE The objective of our study was to evaluate the diagnosis performance of conventional ultrasound combined with a CAD system S-Detect in the category of BI-RADS 4 breast lesions. METHODS Between December 2018 and May 2020, we enrolled patients in this study who received conventional ultrasound and S-Detect before US-guided biopsy or surgical excision. The diagnostic performance was compared between US findings only and the combined use of US findings with S-Detect, which were correlated with pathology results. RESULTS A total of 98 patients (mean age 51.06 ±16.25 years, range 22-81) with 110 breast masses (mean size1.97±1.38cm, range0.6-8.5) were included in this study. Of the 110 breast masses, 64/110 (58.18%) were benign, 46/110 (41.82%) were malignant. Compared with conventional ultrasound, a significant increase in specificity (0% to 53.12%, P<.001), accuracy (41.81% to70.19%, P<.001) were noted, with no statistically significant decrease on sensitivity(100% to 95.65% ,P=.48). According to S-Detect-guided US BI-RADS re-classification, 30 out of 110 (27.27%) breast lesions underwent a correct change in clinical management, 74of 110 (67.27%) breast lesions underwent no change and 6 of 110 (5.45%) breast lesions underwent an incorrect change in clinical management. The biopsy rate decreased from 100% to 67.27 % (P<.001).Benign masses among subcategory 4a had higher rates of possibly benign assessment on S-Detect for the US only (60% to 0%, P<.001). CONCLUSIONS S-Detect can be used as an additional diagnostic tool to improve the specificity and accuracy in clinical practice. S-Detect have the potential to be used in downgrading benign masses misclassified as BI-RADS category 4 on US by radiologist, and may reduce unnecessary breast biopsy. CLINICALTRIAL none

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