title: Serum amyloid A protein is a useful inflammatory marker during late-onset sepsis in preterm infants.
abstract: 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.
authors.affiliation: Department of Neonatology, Meir Hospital, Sapir Medical Center, 59 Tchernichovsky Street, IL-44281 Kfar-Saba, Israel. harnon@netvision.net.il
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
authors.forename: Rivka
authors.initials: R
authors.lastname: Regev
authors.forename: Sofia
authors.initials: S
authors.lastname: Bauer
authors.forename: Monica
authors.initials: M
authors.lastname: Lis
authors.forename: Ruth
authors.initials: R
authors.lastname: Shainkin-Kestenbaum
authors.forename: Tzipora
authors.initials: T
authors.lastname: Dolfin
mesh_terms: 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
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D015850:Interleukin-6; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein