title: Urinary neutrophil gelatinase-associated lipocalin is a promising biomarker for late onset culture-positive sepsis in very low birth weight infants.
abstract: Need for the early identification of sepsis in very low birth weight (VLBW) infants has led to the search for reliable biomarkers. This study aims to determine whether urinary neutrophil gelatinase-associated lipocalin (uNGAL) rises in culture-positive sepsis and, if so, is elevated at the time sepsis is suspected. This is a prospective study of 91 VLBW infants whose urine was collected daily for uNGAL analysis. In 65 episodes of suspected sepsis, four groups were identified: a) culture-positive sepsis; b) single culture positive for Staphylococcus epidermidis; c) and d) negative culture with antibiotic treatment for >or=7 d and <7 d, respectively. Daily means of uNGAL of each group were estimated for comparison. Mean uNGAL in group A (179 ng/mL) was significantly elevated on the day blood culture was drawn (day 0) compared with the mean of healthy VLBW infants (6.5 ng/mL), and to the means in groups B, C, and D (p<0.05). In group A, mean uNGAL was significantly elevated on day 0 and daily for 5 days when compared with that of the day before culture (p<0.05 to <0.005). uNGAL shows promise as an early marker for culture-positive sepsis in VLBW infants.
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. ep127@columbia.edu
authors.forename: Elvira
authors.initials: E
authors.lastname: Parravicini
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Nemerofsky
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Michelson
authors.forename: Trang K
authors.initials: TK
authors.lastname: Huynh
authors.forename: Meghan E
authors.initials: ME
authors.lastname: Sise
authors.forename: David A
authors.initials: DA
authors.lastname: Bateman
authors.forename: John M
authors.initials: JM
authors.lastname: Lorenz
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Barasch
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D042241:Early Diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000652:urine*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D009519:New York City; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000652:urine; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D000209:Acute-Phase Proteins; D000900:Anti-Bacterial Agents; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins