Serum amyloid A protein is a useful inflammatory marker during late-onset sepsis in preterm infants.
BACKGROUND
Few studies demonstrated that serum amyloid A (SAA), a non-specific acute-phase reactant, could be used as a reliable early marker for the diagnosis of late-onset sepsis (LOS).


OBJECTIVE
To evaluate the diagnostic value and the dynamics of SAA levels during the course of LOS and to compare it to those of other inflammatory markers.


METHODS
Levels of SAA, C-reactive protein (CRP) and IL-6 together with clinical variables, biochemical parameters and cultures retrieved from all preterm infants suspected of LOS were checked at the first suspicion of sepsis and after 8, 24, 48 and 72 h. Results were compared to healthy, matched infants.


RESULTS
One hundred and sixteen infants were included in the study, 38 in the sepsis and 78 in the non-sepsis group. High levels of SAA were observed at sepsis onset, with a gradual decline thereafter, while CRP levels increased only at 24 h after sepsis onset. In the sepsis group, levels of SAA returned faster to baseline than CRP levels. Receiver-operating characteristic analysis values revealed that SAA at 10 mug/ml had the highest sensitivity at 0, 8 and 24 h after sepsis onset (95, 100 and 97%, respectively) and a negative predictive value (97, 100 and 98%, respectively).


CONCLUSIONS
SAA is an accurate acute-phase protein during LOS in preterm infants. Quick and reliable SAA kits can make this marker a useful tool in LOS in preterm infants.
Arnon
Shmuel
S
Department of Neonatology, Meir Hospital, Sapir Medical Center, 59 Tchernichovsky Street, IL-44281 Kfar-Saba, Israel. harnon@netvision.net.il
Litmanovitz
Ita
I
Regev
Rivka
R
Bauer
Sofia
S
Lis
Monica
M
Shainkin-Kestenbaum
Ruth
R
Dolfin
Tzipora
T
D000209:Acute-Phase Proteins / Q000032:analysis; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis*; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D018805:Sepsis / Q000175:diagnosis*; D000685:Serum Amyloid A Protein / Q000032:analysis*; D013997:Time Factors
D000209:Acute-Phase Proteins; D015415:Biomarkers; D015850:Interleukin-6; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein