Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
F1000Res. 2023 Nov 9;12:626. doi: 10.12688/f1000research.132099.1. eCollection 2023.
Despite significant advances in neonatal care, neonatal sepsis remains a major contributor to mortality, morbidity, and protracted hospitalization. The development of early possible diagnostic indicators for newborn sepsis is critical. Since calprotectin participates in major biological processes, it could be a diagnostic marker for infection/inflammation. This study aimed to estimate serum calprotectin in neonates with clinical sepsis. In addition, we compared serum calprotectin with standard sepsis markers and serum procalcitonin to evaluate its diagnostic accuracy.
A hospital-based cross-sectional diagnostic study of neonates identified with clinical sepsis using standard criteria was carried out. We compared estimated serum calprotectin levels to serum procalcitonin levels and conventional sepsis markers (leucocyte count, blood culture, immature to total neutrophil ratio, and C- reactive protein). We used SPSS version 25 to analyze the data. To examine diagnostic accuracy and determine a cut-off value for serum calprotectin, we used the receiver operating characteristics (ROC) curve.
Of the 83 subjects included, 36.5% (30/83) had blood culture positive status, the median value of serum calprotectin being 0.93 ng/ml (0.67 to 1.3). Respiratory, cardiovascular, and gastrointestinal instabilities were present in 67.5% (56/83), 59% (49/83), and 50.1% (42/83) cases, respectively. The median values of serum calprotectin, procalcitonin, TLC, and I/T ratio between neonates withpositive blood culturesand negative culturesdid not differ significantly.. On ROC, calprotectin was not predictive for blood culture positivity (sensitivity: 50%; specificity: 44% at 0.83 ng/ml of serum calprotectin) and C-reactive protein (CRP) levels (sensitivity: 57%; specificity: 67% at serum calprotectin levels of 0.89 ng/ml). However, compared with serum procalcitonin, serum calprotectin at 1.2 ng/ml had sensitivity and specificity of 60% and 73%, respectively.
Serum calprotectin did not show a distinct advantage over the existing sepsis markers. Serum calprotectin level at 1.2 ng/ml had a sensitivity and specificity of 60% and 73%, respectively, compared to serum procalcitonin in detecting neonatal sepsis.
尽管新生儿护理取得了重大进展，但新生儿败血症仍是导致死亡率、发病率和延长住院时间的主要原因。开发新生儿败血症早期可能的诊断指标至关重要。由于钙卫蛋白参与主要的生物学过程，它可能是感染/炎症的诊断标志物。本研究旨在评估临床败血症新生儿的血清钙卫蛋白。此外，我们将血清钙卫蛋白与标准败血症标志物和血清降钙素原进行比较，以评估其诊断准确性。
采用基于医院的横断面诊断研究，使用标准标准确定患有临床败血症的新生儿。我们比较了估计的血清钙卫蛋白水平与血清降钙素原水平以及常规败血症标志物（白细胞计数、血培养、未成熟中性粒细胞与总中性粒细胞比值和 C 反应蛋白）。我们使用 SPSS 版本 25 来分析数据。为了检查诊断准确性并确定血清钙卫蛋白的截止值，我们使用了接收者操作特征 (ROC) 曲线。
在 83 名受试者中，36.5%（30/83）血培养阳性，血清钙卫蛋白中位数为 0.93ng/ml（0.67 至 1.3）。67.5%（56/83）、59%（49/83）和 50.1%（42/83）的病例分别存在呼吸、心血管和胃肠道不稳定。血培养阳性和阴性新生儿的血清钙卫蛋白、降钙素原、TLC 和 I/T 比值中位数无显著差异。在 ROC 上，钙卫蛋白对血培养阳性无预测作用（敏感性：50%；特异性：0.83ng/ml 血清钙卫蛋白时为 44%）和 C 反应蛋白（CRP）水平（敏感性：57%；特异性：0.89ng/ml 血清钙卫蛋白时为 67%）。然而，与血清降钙素原相比，血清钙卫蛋白在 1.2ng/ml 时的敏感性和特异性分别为 60%和 73%。
血清钙卫蛋白与现有败血症标志物相比没有明显优势。与血清降钙素原相比，血清钙卫蛋白在 1.2ng/ml 时的敏感性和特异性分别为 60%和 73%，可用于检测新生儿败血症。
