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Plasma secretory phospholipase A2 as an early marker for late‐onset sepsis in preterm infants—a pilot study
Author(s) -
Hibbert Julie,
Armstrong Nicola J.,
Granland Caitlyn,
Ng Sherrianne,
Simmer Karen,
Richmond Peter,
Burgner David,
Strunk Tobias,
Currie Andrew
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15969
Subject(s) - medicine , gestational age , sepsis , antibiotic stewardship , procalcitonin , neonatal sepsis , antibiotics , pediatrics , gastroenterology , pregnancy , microbiology and biotechnology , antibiotic resistance , genetics , biology
Preterm infants are particularly susceptible to bacterial late‐onset sepsis (LOS). Diagnosis by blood culture and inflammatory markers have sub‐optimal sensitivity and specificity and prolonged reporting times. There is an urgent need for more rapid, accurate adjunctive diagnostics in LOS to improve management and minimise antibiotic exposure. We measured the diagnostic performance of secretory phospholipase A2 type IIA (sPLA2‐IIA) in very preterm infants (<30 weeks gestational age) with suspected LOS. Plasma sPLA2‐IIA levels were elevated in infants with LOS ( n = 28) compared to those without LOS ( n = 21; median 30,970 vs. 2534 pg/ml, p < 0.0001). The mean area under the curve was 0.884 (95% CI: 0.771, 0.977) with a sensitivity of 0.907 (95% CI: 0.667, 1.00) and specificity of 0.804 (95% CI: 0.600, 1.00). The positive and negative predictive values were 0.833 (95% CI: 0.664, 0.927) and 0.842 (95% CI: 0.624, 0.945), respectively. This pilot study suggests that sPLA2‐IIA may have clinical utility for the early diagnosis of LOS in very preterm infants, potentially informing clinical management and antibiotic stewardship.