Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) in preterm newborn infants with nosocomial infections.
Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) and their relation to suggestive nosocomial infections (NIs) were investigated in very preterm (VPT) newborn infants. In a retrospective analysis, information of suggestive NI was matched to levels of SAA and hsCRP in 224 serum samples from 72 VPT newborn infants. As a control group, 35 healthy-term newborn infants were chosen. Of the 224 serum samples, 145 samples were not associated with nosocomial infections. However, 79 were associated with NI: of these 79, 42 were found to be culture-proven NI. Trimmed mean (alpha= 0.05) levels for SAA and hsCRP in VPT newborn infants were higher than in control term newborn infants (1.74, 2.67 mg/L vs. 0.78, 0.16 mg/L; p = 0.01 and <0.0001, respectively), and higher in the NI group than in the non-NI group (5.14, 5.74 mg/L vs. 1.03, 1.18; p < 0.01 and <0.0001; respectively). The areas under the curve (AUC) for hsCRP, calculated from the receiver-operator characteristic (ROC) curves, was greater (0.816; 95% CI 0.759-0.864) than for SAA (0.610; 95% CI 0.543-0.675).


CONCLUSIONS
Identifying and monitoring of bacterial and fungal infections in VPT might be further improved by the use of SAA and hsCRP.
Lannergård
A
A
Department of Medical Sciences, Section of Infectious Diseases, and Clinical Chemistry, Uppsala University, Uppsala, Sweden. anders.lannergard@akademiska.se
Larsson
A
A
Friman
G
G
Ewald
U
U
D001424:Bacterial Infections / Q000097:blood / Q000453:epidemiology; D002097:C-Reactive Protein / Q000378:metabolism*; D003428:Cross Infection / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010865:Pilot Projects; D012189:Retrospective Studies; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein