Biomarker combinations in predicting sepsis in hospitalized children with fever

Abstract

Sepsis is among the leading causes of critical illness worldwide. It includes physiologic, pathologic, and biochemical abnormalities, induced by infection. Novel methods for recognizing a dysregulated inflammatory response and predicting associated mortality must be developed. Our aim was to investigate biomarkers that characterize a pro-inflammatory and anti-inflammatory response in patients with fever by comparing predictive validity for sepsis. 165 patients with fever were enrolled in this study, 55 of them had sepsis according to pSOFA criteria. All patients had blood samples drawn at the time of inclusion and after 24 h. CRP, PCT and also IL-6, IL-8 and sFAS levels were significantly higher in patients with sepsis. The AUC of CRP to predict sepsis was 0.799, all the other biomarkers had AUC’s lower than that. Cytokines, when used as a single marker, did not show a significant diagnostic performance We analyzed various models of biomarker combinations. CRP combined with sFAS showed increase in sensitivity in predicting sepsis (88% vs. 83%). The highest AUC was achieved, when CRP, IL-6, sFAS and sVCAM-1 markers were combined 0.830 (95% CI 0.762–0.884) with a sensitivity of 70% and specificity of 84%. vs. 0.799 for CRP alone.

Platelet-Derived Biomarkers: Potential Role in Early Pediatric Serious Bacterial Infection and Sepsis Diagnostics

“…Lately, more new diagnostic markers have been researched to distinguish early viral versus bacterial infection (including sepsis). The existence of discriminating biomarkers as such during an infectious or non-infectious cause (e.g., trauma) could lead to better screening, diagnosis, prognosis (risk stratification), therapeutic response monitoring, and antibiotic rationalization [ 9 , 10 , 11 , 12 ].…”

Биологические Маркеры Сепсиса

“…Использование показателя CRP в сочетании с растворимой формой белка-регулятора апоптоза sFAS привело к повышению чувствительности в прогнозировании сепсиса до 88%. При объединении маркеров CRP, IL6, sFAS и растворимой формы молекулы адгезии VCAM-1 (sVCAM-1) чувствительность составила 70%, а специфичность -84% [49].…”

Biological markers of sepsis

“…The use of the combination of CRP with the soluble form of sFAS protein, an apoptosis regulator, increased sepsis prediction sensitivity up to 88%. When combining CRP, IL6, and sFAS markers with the soluble form of the adhesion molecule VCAM-1 (sVCAM-1), sensitivity reached 70%, while specificity was 84% [49].…”