Objectives: To investigate postnatal lipopolysaccharide-binding protein (LBP) kinetics in term neonates and to test its diagnostic accuracy for earlyonset bacterial infection (EOBI).Study design: A total of 99 neonates with clinical and serological signs of EOBI comprised the study group; 198 neonates with risk factors, but without EOBI, served as controls. LBP, C-reactive protein (CRP) and interleukin-8 (IL-8) were determined.Results: LBP in the noninfected group increased until 24 h after birth (P<0.05 vs 6 h). LBP and CRP correlated strongly in neonates with suspected EOBI (r ¼ 0.63). Although LBP reached a higher sensitivity than CRP 6 and 12 h after clinical suspicion (45 (24-68) and 79% (54-94) vs 9 (0-24) and 39% (17-64); P<0.05)), EOBI was most reliably detected by IL-8.
Conclusion: LBP kinetics were age-dependent. LBP was not sufficiently sensitive in the prediction of EOBI.
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