Neopterin levels and systemic inflammatory response syndrome in pediatric critically ill patients

Gil-Gómez, Raquel; Blasco‐Alonso, Javier; Sánchez-Yáñez, Pilar; Rosa-Camacho, Vanessa; Milano, Guillermo

doi:10.1016/j.anpede.2017.02.002

Anales de Pediatría (English Edition)

2017

DOI: 10.1016/j.anpede.2017.02.002

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Neopterin levels and systemic inflammatory response syndrome in pediatric critically ill patients

Raquel Gil-Gómez

Javier Blasco‐Alonso

Pilar Sánchez-Yáñez

et al.

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Cited by 2 publications

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“…Prior inotrope administration and C‐reactive proteins were associated with microbiological failure. Gil‐Gómez et al associated a higher need for vasoactive inotropic drugs with the levels of immune system biomarkers associated with increased oxidative stress and worse outcomes in PICU patients. Furthermore, C‐reactive proteins have been associated with severe sepsis and systemic inflammatory response syndrome …”

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“…The PRISM ΙΙΙ‐24 score and carbapenem resistance were predisposing factors for mortality, while source control was associated with favourable outcomes. PRISM ΙΙΙ‐24 scores have also been associated with levels of immune system biomarkers . Carbapenem‐resistant strains are usually resistant to all beta‐lactams and to many non‐beta‐lactam agents, including quinolones and aminoglycosides .…”

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Risk factors for carbapenem resistance and outcomes when treating bloodstream infections in a paediatric intensive care unit

et al. 2019

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52.4%) Risk factor multivariable analysis revealed that prior carbapenem use (OR 3.86, 95% CI 1.10-13.82, P = .03) and renal replacement therapy (OR 3.86, 95% CI 1.10-13.82, P = .03) were associated with carbapenem resistance (Table S1).Gram-negative bacteria have spread rapidly, made infections difficult to treat and developed complicated mechanisms for acquiring resistance. Prior carbapenem use was an important independent risk factor, as PICU patients are exposed to many antibiotics, including carbapenems, 3 underlining the need for rational antibiotic use. Renal failure predisposes patients to carbapenem resistance, due to more invasive procedures, exposure to resistant hospital organisms, antibiotic use and vulnerability to endogenous resistance.Prior inotrope administration and C-reactive proteins were associated with microbiological failure. Gil-Gómez et al 4 associated a higher need for vasoactive inotropic drugs with the levels of immune system biomarkers associated with increased oxidative stress and worse outcomes in PICU patients. Furthermore, C-reactive proteins have been associated with severe sepsis and systemic inflammatory response syndrome. 5The PRISM ΙΙΙ-24 score and carbapenem resistance were predisposing factors for mortality, while source control was associated with favourable outcomes. PRISM ΙΙΙ-24 scores have also been associated with levels of immune system biomarkers. 4 Carbapenem-resistant 1924 | BRIEF REPORT strains are usually resistant to all beta-lactams and to many nonbeta-lactam agents, including quinolones and aminoglycosides. 2 This limits the therapeutic potential and increases the possibility of inappropriate empirical patient treatment. Source control reduces mortality and is a high priority, as inappropriate empirical treatment can be used to tackle severe multi-drug resistant infections.Removing the source of infection can reduce the bacterial burden and eliminate biofilms that could complicate treatment or lead to persistent or recurrent infections.

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Risk factors for carbapenem resistance and outcomes when treating bloodstream infections in a paediatric intensive care unit

et al. 2019

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High Plasma Levels of Neopterin Are Associated with Increased Mortality among Children with Severe Malaria in Benin

et al. 2023

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Among the barriers to accessing adequate treatment and high-level monitoring for malaria febrile patients is the lack of effective prognostic markers. Neopterin, which is a marker of monocyte/macrophage activation, was found have increased during severe malaria. In this study, we used quantitative ELISA in order to assess the levels of plasma soluble neopterin in 151 patients from a cohort of Beninese children with severe malaria. We evaluated the prognostic accuracy of this molecule in order to predict the outcome of the disease. Our results show that neopterin levels were not significantly different between patients with different forms of severe malaria, including severe non-cerebral malaria (SNCM) and cerebral malaria (CM). However, the levels of this molecule were found to be higher in patients with severe malarial anemia (SMA) among both CM and SNCM cases (p-value = 0.02). Additionally, the levels of this molecule were found to be higher in patients who died from these pathologies compared to those who survived among the two clinical groups (p-value < 0.0001) and within the same group (p-value < 0.0001 for the CM group, p-value = 0.0046 for the SNCM group). The AUC-ROC for fatality among all the severe cases was 0.77 with a 95%CI of (0.69–0.85). These results suggest that plasma neopterin levels constitute a potential biomarker for predicting fatality among severe falciparum malaria patients.

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Neopterin levels and systemic inflammatory response syndrome in pediatric critically ill patients

Cited by 2 publications

References 21 publications

Risk factors for carbapenem resistance and outcomes when treating bloodstream infections in a paediatric intensive care unit

Risk factors for carbapenem resistance and outcomes when treating bloodstream infections in a paediatric intensive care unit

High Plasma Levels of Neopterin Are Associated with Increased Mortality among Children with Severe Malaria in Benin

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