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.
Department of Medical Sciences, Section of Infectious Diseases, and Clinical Chemistry, Uppsala University, Uppsala, Sweden. anders.lannergard@akademiska.se
A
A
Lannergård
A
A
Larsson
G
G
Friman
U
U
Ewald
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