title: Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein.
abstract: OBJECTIVE
  To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP).
  
  
  METHODS
  Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit.
  
  
  METHODS
  Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis ( n=33) and SIRS/no sepsis ( n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children.
  
  
  METHODS
  Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated.
  
  
  RESULTS
  Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children.
  
  
  CONCLUSIONS
  In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.
authors.affiliation: Department of Pediatric Surgery and Intensive Care, University Medical Center Ljubljana, Zaloska 7, 1525 Ljubljana, Slovenia. maja.pavcnik@kclj.si
authors.forename: Maja
authors.initials: M
authors.lastname: Pavcnik-Arnol
authors.forename: Sergej
authors.initials: S
authors.lastname: Hojker
authors.forename: Metka
authors.initials: M
authors.lastname: Derganc
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015278:Intensive Care Units, Pediatric; D015850:Interleukin-6 / Q000097:blood; D008562:Membrane Glycoproteins / Q000097:blood*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis*; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide; D002352:Carrier Proteins; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D000099231:Lipopolysaccharide-Binding Protein; C000606589:CALCA protein, human