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

Abstract

Early 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.

Study of Phospholipase A2 Levels and Its Comparison With Procalcitonin Levels in Patients With Sepsis Admitted in a Tertiary Care Hospital, Karnataka, India

“…The mean age of the sepsis patients in our study was 55.60±17.20 years, and there were more males (57.63%) than females (42.37%) in this group. This finding is in agreement with studies by Tan et al, Deme et al, and Anglès et al as well as other previous studies, as they also found similar mean ages between the groups and a male preponderance [2,[14][15][16][17]. Another study by Tan et al, also documented a similar mean age, although the distribution of males and females was equal in their study [18].…”

“…The current study observed significantly higher mean PCT and PLA2 in sepsis patients when compared to the non-sepsis group. This was supported by Tan et al and Anglès et al who also found these biomarkers to be elevated in sepsis patients [14,16]. Tambo et al and Varela-Patiño et al also found a strong association between PCT and sepsis [19,20].…”

Secretory phospholipase A2: a biomarker of inflammation in autoimmune, bacterial and viral diseases

“…Не было установлено корреляций между sPLA2 и уровнями CRP, D-димера и количеством лейкоцитов [39]. Вместе с тем установлены положительные корреляции уровня sPLA2-IIA с показателями NEWS2, уровнем глюкозы и отрицательные с креатинином мочевины, скоростью клубочковой фильтрации, гематокритом, сатурацией гемоглобина, что также подтверждает зависимость sPLA2-IIA от тяжести COVID-19 инфекции [103,104].…”

Human Group IIA Phospholipase A2—Three Decades on from Its Discovery

“…The first clinical study to determine serum PLA 2 activity, subsequently shown to be hGIIA activity, in any disease established an association between this activity and severity of disease in sepsis and septic shock [ 18 ]. This relationship is robust with hGIIA being recognized as a key biomarker and predictor of mortality in this disease [ 105 , 106 ]. In addition, a single study establishes that hGIIA is also an important marker in combination with procalcitonin in predictively distinguishing patients with sepsis from patients with noninfectious systemic inflammatory response syndrome on presentation at Emergency Departments (ED) [ 107 ].…”