title: Clinical value of plasma soluble urokinase-type plasminogen activator receptor levels in term neonates with infection or sepsis: a prospective study.
abstract: BACKGROUND
  suPAR, the soluble form of the urokinase-type plasminogen activator receptor, has been identified as a biomarker of infection in adults but its properties in neonatal infection are not known.
  
  
  METHODS
  Plasma suPAR levels were determined by ELISA in 47 term neonates with infection (19 bacterial and 28 viral) and in 18 healthy neonates as controls. Thirteen out of 47 infected neonates were septic. In all infected neonates, suPAR levels were repeated at 24 hours, 48 hours, 3-5 days, and 7-10 days following admission.
  
  
  RESULTS
  Plasma suPAR levels were significantly increased in infected neonates upon admission, whereas they were highest in septic neonates, in comparison with controls (P < 0.001) and correlated positively with serum CRP levels (P = 0.001). At infection subsidence, suPAR concentrations decreased significantly in comparison with baseline (P < 0.001) but remained higher than in controls (P = 0.01). Receiver operating characteristic analysis resulted in significant areas under the curve for detecting either infected or septic neonates, but not for discriminating between bacterial and viral cause of infection.
  
  
  CONCLUSIONS
  suPAR is a diagnostic biomarker of infection or sepsis in term neonates; however, it cannot discriminate bacterial from viral infections and also its utility for monitoring the response to treatment is questioned.
authors.affiliation: Neonatal Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Tania
authors.initials: T
authors.lastname: Siahanidou
authors.affiliation: Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Margeli
authors.affiliation: Neonatal Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Chrysanthi
authors.identifier: 0000-0002-8831-2273
authors.initials: C
authors.lastname: Tsirogianni
authors.affiliation: Neonatal Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Charoni
authors.affiliation: Department of Microbiology, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Giannaki
authors.affiliation: Hematology Laboratory, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Eustathios
authors.initials: E
authors.lastname: Vavourakis
authors.affiliation: Department of Microbiology, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Charisiadou
authors.affiliation: Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, 115 27 Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papassotiriou
mesh_terms: D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood* / Q000502:physiology*; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis; D013997:Time Factors; D014777:Virus Diseases / Q000097:blood* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; C524898:PLAUR protein, human; D055293:Receptors, Urokinase Plasminogen Activator