Serum amyloid A: an early and accurate marker of neonatal early-onset sepsis

Abstract

Objectives: To evaluate the accuracy of serum amyloid A (SAA), an acute phase protein in the detection of neonatal early-onset sepsis, by means of a fast automated SAA kit.Study Design: Full-term infants <72 h of age, who had risk factors and/or were suspected of having sepsis, were eligible for study. The levels of SAA were taken at 0, 24 and 48 h post sepsis evaluation. Thirty matched infants served as a control group for comparing SAA concentrations.Results: Of 104 infants eligible for entry to the study, 23 had sepsis and 81 had not sepsis. The SAA levels of the septic group were significantly higher than those of the nonseptic group at 0, 24 and 48 h (P<0.01 for all time points). In comparison with C-reactive protein (CRP), SAA levels rose earlier and in a sharper manner, had higher levels and returned faster to normal values in infants with early onset sepsis. At 0 h post-sepsis evaluation, serum SAA had an overall better diagnostic accuracy for predicting early onset sepsis than CRP (sensitivity (96 vs 30%), specificity (95 vs 98%), positive predictive value (85 vs 78%), negative predictive value (99 vs 83%), positive likelihood ratio (19 vs 12), and negative likelihood ratio (0.05 vs 0.71).Conclusions: SSA is advocated as an inflammatory marker of neonatal early-onset sepsis.

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

“…31 They established that SAA had higher levels, and rose earlier and sharper than CRP. 10 In our study, we found that SAA had higher levels during the initial and 48-h evaluation of infants with sepsis. We have also shown that it declined faster than CRP and PCT during the follow-up of sepsis.…”

“…SAA has been shown to be useful in various acute diseases (bacterial, viral, traumatic, rheumatic and ischemic heart disease) and also in the diagnosis of sepsis in neonates. 3,[9][10][11] Although the data about its use in diagnosis of neonatal sepsis is limited, recently it has been suggested as a superior marker compared with CRP. 12 CRP is a protein produced by the liver in response to inflammatory and/or infectious stimuli, and for this reason it is regarded as an acute-phase protein.…”

Serum Amyloid A, Procalcitonin, Tumor Necrosis Factor‐α, and Interleukin‐1β Levels in Neonatal Late‐Onset Sepsis

“…Warning signs and symptoms are often subtle and can easily be confused with noninfective causes such as apnea, hypothermia, and acute exacerbation of chroniclung disease. So that hematological and biochemical markers such as immature/total neutrophil ratio, platelet count, C-reactive protein (CRP), various cytokines, procalcitonin (PCT), and tumornecrosis factor- α (TNF- α ) have been proposed as being useful indicators for early identification of septic infants [1–4]. Recently, SAA that refers to a group of polymorphic apolipoproteins 12–14 kDa, mainly produced by the liver, has been proposed as a new discriminative marker of bacterial infection [1, 3–6].…”

Comparison of the efficacy of serum amyloid A, C-reactive protein, and procalcitonin in the diagnosis and follow-up of necrotizing enterocolitis in premature infants

“…Levels of SAA increase up to 1000 fold in the 8 to 24 hours after the onset of inflammation. Serum amyloid A has been shown to be useful in various acute diseases (bacterial, viral, traumatic, rheumatic, and ischemic heart disease) and also in neonatal sepsis [16][17][18]. Recently, we have shown that SAA might be used as an accurate marker in addition to clinical and laboratory findings in the diagnosis of NEC [19].…”