Diagnostic utility of elevated serum soluble triggering receptor expressed on myeloid cells (sTREM)-1 in infected neonates.
OBJECTIVE
To assess the value of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for early diagnosis of late-onset sepsis (LOS) in neonates, compared with interleukin-6 (IL-6).


METHODS
Prospective, observational study in a single, level III neonatal intensive care unit of a university hospital.


METHODS
Fifty-two preterm and term neonates evaluated for suspected LOS were studied. Neonates were classified into two groups: infected [confirmed sepsis (n = 22) and possible sepsis (n = 9)] and noninfected neonates (n = 21).


RESULTS
Serum sTREM-1 and IL-6 were measured (enzyme-linked immunosorbent assays) when signs suggestive of sepsis emerged. Infected neonates had significantly higher sTREM-1 (p = 0.004) and IL-6 (p < 0.0001) than noninfected neonates. Receiver operating characteristic (ROC) curve analysis resulted in significant areas under the curve (AUC) for both sTREM-1 (AUC = 0.733, p = 0.005) and IL-6 (AUC = 0.892, p = 0.001) for identification of infected neonates, with the difference between the two AUC not being significant. Further analysis documented acceptable diagnostic performance of sTREM-1 and IL-6, which was not improved, however, when the two markers were combined.


CONCLUSIONS
Serum sTREM-1 increases in infected neonates. Diagnostic accuracy of sTREM-1 either alone or in combination with IL-6 is not better than that of IL-6.
1st Department of Neonatology of Aristotle, University of Thessaloniki, Hippokration General Hospital, Kostantinoupoleos 49, Thessaloniki, Greece. saraf@med.auth.gr
Kosmas
K
Sarafidis
Vasiliki
V
Soubasi-Griva
Kaliopi
K
Piretzi
Agathi
A
Thomaidou
Eleni
E
Agakidou
Anna
A
Taparkou
Elisavet
E
Diamanti
Vasiliki
V
Drossou-Agakidou
D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D007363:Intensive Care Units, Neonatal; D015850:Interleukin-6 / Q000097:blood*; D008562:Membrane Glycoproteins / Q000097:blood*; D011446:Prospective Studies; D011971:Receptors, Immunologic / Q000097:blood*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000382:microbiology; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
D015415:Biomarkers; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1