Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein

Abstract

In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.

Lipopolysaccharide-binding protein in noninfected neonates and those with suspected early-onset bacterial infection

“…8 Its induction occurs at 12 h 9 after stimulation with both Gramnegative, for example, Escherichia coli, 10 and Gram-positive bacteria, for example, Streptococcus agalactiae, 11 the two most important inducers of EOBI. Elevated LBP concentrations were found in cord blood of culture-proven EOBI, 12 septic neonates within 48 h, 13 and preterm neonates 12 h after bacterial infection. 14 Since LBP in the early postnatal phase has not been investigated, we were interested in its kinetics in noninfected term neonates and those with suspected EOBI, and tested the hypothesis that LBP may serve as an accurate parameter in the prediction of EOBI.…”

Diagnostic Markers for Early Sepsis Diagnosis in Children With Systemic Inflammatory Response Syndrome

“…Several studies suggest that PCT provides less diagnostic accuracy than previously supposed (Pavcnik-Arnol et al, 2004;Thayyil et al, 2005;Gaini et al, 2006). Our results match the literature data in respect to the correlation between PCT level and the intensity of inflammation.…”

“…Our results on the LBP ability to diagnose sepsis partly substantiates this sensitivity 79.9% and specificity 50.8%, with a cut-off level of 24.5 mg/ml. In other studies, a cut-off level of 20 mg/ml LBP was associated with 91% sensitivity and 85% specificity (Pavcnik-Arnol et al, 2004); 81% sensitivity and 68.4% (Gaini at al., 2006). LBP did not perform perfectly on ROC analysis in its ability to identify sepsis patients, with an AUC of 0.73 which differs from that reported in a study by Pavcnik-Arnol et al (2007): AUC for LBP was 0.97 in neonates aged under 48 h, 0.93 in neonates over 48 h and 0.82 in older children.…”

“…Increased serum LBP levels have been reported in children with sepsis (Berner et al, 2002;Pavcnik-Arnol et al, 2004;Ubernauf et al, 2007).…”

Cellular and Molecular Markers of Outcome in Septic Shock

“…The authors suggested that monitoring of serum LBP could, therefore, help to target cirrhotic patients with ascites for antibiotic prophylaxis (Albillos et al 2004). However, LBP measurements in ICU patients with SIRS and sepsis have not been found any benefit (Prucha et al 2003), except in selected patient populations as heart surgery, neonates or neutropenic patients (Pavcnik-Arnol et al 2004;Sablotzki et al 2001). …”