Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study

Misset, Benoît; Philippart, François; Rouquette, Alexandra; Moucadel, Virginie; Puchois, Virginie; Blein, Sophie; Bédos, Jean‐Pierre; Diehl, Jean‐Luc; Hamzaoui, Olfa; Annane, Djillali; Journois, Didier; Boutieb, Myriam Ben; Esteve, Laurent; Fitting, Catherine; Tréluyer, Jean‐Marc; Pachot, Alexandre; Adib‐Conquy, Minou; Cavaillon, Jean‐Marc

doi:10.1007/s00134-018-5228-3

Cited by 60 publications

(57 citation statements)

References 38 publications

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“…The area under the curve (AUC) of the ROC curve, which was 0.948, confirmed a significant interest for this biomarker. In a recent study, Parlato et al have found that CRP is the best biomarker which emerged in diagnosing sepsis [9].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies are currently assessing laboratory inflammatory biomarkers in the diagnosis of neonatal sepsis. Recent studies among them have suggested the use of CRP biomarker [8,9] for the precocious diagnosis of neonatal sepsis. It has been shown that no combination of biomarkers performs well in diagnosing sepsis like CRP alone [9].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies among them have suggested the use of CRP biomarker [8,9] for the precocious diagnosis of neonatal sepsis. It has been shown that no combination of biomarkers performs well in diagnosing sepsis like CRP alone [9]. Current available diagnostic tools are not so useful in the decision to initiate empiric antibiotic therapy in neonates suspected with sepsis but may help in the decision to discontinue antibiotic therapy [10].…”

Section: Introductionmentioning

confidence: 99%

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The usefulness of C-reactive protein as a biomarker in predicting neonatal sepsis in a sub-Saharan African region

Bunduki

Adu‐Sarkodie

2020

BMC Res Notes

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Objective: The early diagnosis of neonatal sepsis remains a challenge for physicians. The initiation or/and discontinuation of the empirical antibiotic therapy at neonates with sepsis is a dilemma due to the lack of definitive diagnosis and the fear of misdiagnosing a case with its serious outcomes, which can follow up. Therefore, this study aimed to assess the usefulness of C-reactive protein (CRP) as an inflammatory biomarker in the prediction of the neonatal sepsis diagnosis in Butembo, the Democratic Republic of the Congo, in sub-Saharan Africa. Blood culture and quantitative CRP measurements were performed for each neonate. Receiver operating characteristics (ROC) analyses were done in the assessment of CRP accuracy in diagnosing neonatal sepsis. Results: Of the 228 neonates screened for sepsis, 69 (30.3%) had a positive blood culture. Of the 228 neonates with suspected sepsis, 94 (41.2%) had a positive CRP. Among the 69 cases with positive blood culture, CRP identified 66 cases. The sensitivity, specificity, positive and negative predictive values of CRP were 95.7%, 82.4%, 70.2%, and 97.8%, respectively. The area under the curve (AUC) for the CRP ROC analysis was 0.948. CRP showed its usefulness in the diagnosis of neonatal sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The usefulness of C-reactive protein as a biomarker in predicting neonatal sepsis in a sub-Saharan African region

Bunduki

Adu‐Sarkodie

2020

BMC Res Notes

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“…sterilen, nichtinfektiologisch bedingten Inflammationsreaktionen (z. B. nach Trauma) abzugrenzen [6,13]. Der Wert infektiologischer Biomarker wie Procalcitonin (PCT) oder C-reaktives Protein (CRP) liegt im infektiologischen Management (Therapieeffizienz, Dauer der antimikrobiellen Therapie, Therapieversagen) septischer Patienten auf der Intensivstation [14].…”

Section: Stellenwert Von Biomarkern In Der Sepsisunclassified

“…der Detektion der Infektion bewusst nicht mehr berücksichtigt. Dies liegt darin begründet, dass gerade in der frühen Phase der Sepsis aktuell kein Biomarker (oder eine Kombination aus diesen) hinreichend spezifisch oder sensitiv ist, um eine Sepsis sicher diagnostizieren und gegen andere Erkrankungen abgrenzen zu können [6].…”

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Diagnostik der Sepsis – Teil 1: allgemeine Diagnostik und Fokussuche-/sanierung

Richter¹,

Heininger²,

Schmidt³

et al. 2019

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungDie Sepsis ist ein medizinischer Notfall mit weiterhin hoher Sterblichkeit. Die Surviving Sepsis Campaign (SSC) gibt für die Diagnostik und die Gabe eines adäquaten Breitspektrumantibiotikums ein Zeitfenster von max. 1 h nach Stellen der Verdachtsdiagnose „Sepsis“ vor. Aktuell wird dieses sog. 1 h-Maßnahmenbündel kritisch diskutiert. Als Kernaspekt der Fokussuche orientiert sich die Art der Bildgebung am vermuteten Fokus und dem Patientenkollektiv. Bei kritisch kranken Patienten ist die kontrastmittelverstärkte Computertomografie häufig Mittel der Wahl. Die Erregerdetektion erfolgt meist kulturbasiert. Daher sind mikrobiologische Proben aus einfach zugänglichen Kompartimenten, mindestens aber die Entnahme von 2 Blutkultursets, obligat und sollten vor der Gabe eines Antibiotikums erfolgen. Von herausragender Bedeutung sind vor allem intraoperative Abstriche aus sonst sterilen Kompartimenten. Suspekte Katheter (z. B. zentralvenöse Katheter, Dialysekatheter) oder potenziell infizierte implantierte Medizinprodukte (z. B. Schrittmacher, Defibrillatoren) sollten – wenn vertretbar – zügig entfernt und einer mikrobiologischen Aufarbeitung zugeführt werden. Generell sollten alle notwendigen Maßnahmen zur Fokussanierung/-kontrolle so schnell wie medizinisch/logistisch möglich, mindestens aber innerhalb von 6(– 12)h nach Beginn der Sepsis, erfolgt sein. Es existiert bislang kein spezifischer Biomarker für das Krankheitsbild der Sepsis. Biomarker wie das Procalcitonin (PCT) und das C-reaktive Protein (CRP) spielen im Kontext der Sepsis beim infektiologischen Management und Therapiemonitoring auf der Intensivstation eine wichtige Rolle. Vielversprechende Biomarker wie das midregionale Pro-Adrenomedullin (MR-proADM) oder das Presepsin werden außerhalb von Studien noch nicht in der klinischen Routine eingesetzt. Als Marker von Mikrozirkulationsstörungen und eines gestörten Metabolismus spielt das Laktat (bzw. die Laktat-Clearance) als prognostischer Parameter der Sepsis eine große Rolle.

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Feature selection for OPLS discriminant analysis of cancer tissue lipidomics data

et al. 2019

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The mass spectrometry-based molecular profiling can be used for better differentiation between normal and cancer tissues and for the detection of neoplastic transformation, which is of great importance for diagnostics of a pathology, prognosis of its evolution trend, and development of a treatment strategy. The aim of the present study is the evaluation of tissue classification approaches based on various data sets derived from the molecular profile of the organic solvent extracts of a tissue. A set of possibilities are considered for the orthogonal projections to latent structures discriminant analysis: all mass spectrometric peaks over 300 counts threshold, subset of peaks selected by ranking with support vector machine algorithm, peaks selected by random forest algorithm, peaks with the statistically significant difference of the intensity determined by the Mann-Whitney U test, peaks identified as lipids, and both identified and significantly different peaks. The best predictive potential is obtained for OPLS-DA model built on nonpolar glycerolipids (Q 2 = 0.64, area under curve [AUC] = 0.95); the second one is OPLS-DA model with lipid peaks selected by random forest algorithm (Q 2 = 0.58, AUC = 0.87). Moreover, models based on particular molecular classes are more preferable from biological point of view, resulting in new explanatory mechanisms of pathophysiology and providing a pathway analysis. Another promising features for OPLS-DA modeling are phosphatidylethanolamines (Q 2 = 0.48, AUC = 0.86). Journal of MASS SPECTROMETRY 4 | CONCLUSION ESI-MS shotgun lipidomics of a tissue takes about 25 minutes including sample preparation. It is somewhat faster than the common cervical cancer identification methods such as histology and can give significantly more information. Thus, it has a potential for precise and personalized characterization of cancer as a supplement for histological examination. Influence of pre-analytical experimental data processing on the classification model predictive potential is analyzed.The OPLS-DA model based on nonpolar glycerolipids demonstrated the best predictive power. These data sets together with ethanolamines are the most promising for tissue classification among the data bearing essential biochemical information.

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Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study

Abstract: The circulating biomarkers tested were found to discriminate poorly between sepsis and non-septic SIRS, and no combination performed better than CRP alone.

Cited by 60 publications

References 38 publications

The usefulness of C-reactive protein as a biomarker in predicting neonatal sepsis in a sub-Saharan African region

The usefulness of C-reactive protein as a biomarker in predicting neonatal sepsis in a sub-Saharan African region

Diagnostik der Sepsis – Teil 1: allgemeine Diagnostik und Fokussuche-/sanierung

Feature selection for OPLS discriminant analysis of cancer tissue lipidomics data

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