The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis

Li, Peijuan; Wang, Chunmei; Pang, Shuqin

doi:10.23736/s0375-9393.21.15585-3

Cited by 24 publications

(24 citation statements)

References 26 publications

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“…There were 11 full text articles that underwent full review, and four studies were eligible for inclusion in the final systematic review [ 20 – 31 ]. Of the seven excluded studies six were excluded because the index test was not MR-proADM and one study was excluded because it only reported the differences in cord blood concentrations of MR-proADM in newborns with and without risk factors for infection [ 26 – 31 ]. Two of the six eligible studies reported on adult and paediatric data [ 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic value of mid-regional pro-Adrenomedullin as a biomarker of invasive bacterial infection in children: a systematic review

et al. 2022

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Background Invasive bacterial infections (IBI) in children present a difficult clinical challenge. They are often life-threatening, however in the early stages they can be hard to differentiate from benign viral infections. This leaves clinicians with the risk of missing a serious IBI diagnosis or inappropriately using antimicrobials in a child with a viral infection- contributing to the ongoing development of increased antimicrobial resistance. Hence, biomarkers which could aid in early detection of IBI and differentiation from viral infections are desirable. Mid-Regional pro-Adrenomedullin (MR-proADM) is a biomarker which has been associated with IBI. The aim of this systematic review was to determine its diagnostic accuracy in identifying children with IBI. Methods A strategy was devised to search online databases MEDLINE, Embase, Web of Science and Scopus for human clinical trials reporting the accuracy of MR-proADM in children. Against predesigned inclusion and exclusion criteria full texts were selected for inclusion and data extraction. True positives, false positives, true negatives and false negatives were extracted from each included study to fill 2 × 2 tables. Using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool methodological quality of each study was assessed. Results A total of 501 articles were initially identified. After the removal of duplicates and abstract screening 11 texts were fully reviewed and four texts (totaling 1404 patients) were included in the systematic analysis. Only one study was of a high quality and that study accounted for the vast majority of patients. A single study reported the diagnostic accuracy of MR-proADM for invasive bacterial infection reporting an Area under the Curve of 0.69. The paucity of available studies made meta-analysis and studies of heterogeneity impossible. Conclusion There is a paucity of research regarding the diagnostic accuracy of MR-proADM in the diagnosis of invasive bacterial infections in children. Initial results would suggest that MR-proADM testing alone is poor at identifying IBI in young children. It remains unclear if MR-proADM performs differently in older children or in children with signs and symptoms of IBI. Trial registration PROSPERO CRD42018096295.

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Section: Resultsmentioning

confidence: 99%

“…This would mirror the literature related to MR-proADM in adult populations where there have been significantly more studies. Reviews of MR-proADM in adult populations have not been able to demonstrate utility as a diagnostic tool for IBI but rather as a predictor of clinical sepsis and referral to intensive care units [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of mid-regional pro-Adrenomedullin as a biomarker of invasive bacterial infection in children: a systematic review

et al. 2022

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“…Its diagnostic and prognostic value has been investigated in several clinical studies, which confirmed pro-ADM as a good biomarker in assessing a patient’s initial state, evolution, and prognosis. Uncertainties remain about the best cut-off for the early diagnosis of sepsis and for predicting patient prognosis, and further studies are needed to highlight several dark gaps about pro-ADM release kinetic and average half-life in the bloodstream in order to reduce the risk of false-positive or -negative results [ 126 , 127 ].…”

Section: Diagnosis Of Sepsismentioning

confidence: 99%

The Interplay between Host Defense, Infection, and Clinical Status in Septic Patients: A Narrative Review

Lazzaro

Girolamo

Filippi

et al. 2022

IJMS

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Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Despite significant morbidity and mortality throughout the world, its pathogenesis and mechanisms are not clearly understood. In this narrative review, we aimed to summarize the recent developments in our understanding of the hallmarks of sepsis pathogenesis (immune and adaptive immune response, the complement system, the endothelial disfunction, and autophagy) and highlight novel laboratory diagnostic approaches. Clinical management is also discussed with pivotal consideration for antimicrobic therapy management in particular settings, such as intensive care unit, altered renal function, obesity, and burn patients.

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“…Proadrenomedullin (proADM) plays an important role in the inflammation and infective process and showed a good performance as a new biomarker in septic disease [38]. Whereas some studies evaluated proADM impact in the treatment management of UTIs [39][40][41], no study evaluated its possible role in the discrimination between UTIs and ABU.…”

Section: Proadrenomedullinmentioning

confidence: 99%

Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

Martino

Novara

2022

IJTM

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Urinary tract infections (UTIs) are among the most common infective disease in the adult population. UTI diagnosis is based essentially on the presence of lower urinary tract symptoms (e.g., dysuria, urgency, and frequency) and the evidence of bacteriuria (by dipstick testing and/or urine culture). UTI diagnosis is not always easy because symptoms can be vague, or patient basal conditions can interfere negatively with the diagnostic process, whereas urine culture is still ongoing. In those cases, the differential diagnosis among UTIs and asymptomatic bacteriuria (ABU) may be challenging, while the clinician has to decide whether to start an antibiotic treatment shortly. The purpose of the present review is to analyze the biomarkers that could help in UTI diagnosis. Some biomarkers, such as procalcitonin, interleukin-6, neutrophil gelatinase-associated lipocalin, chemokines, lactoferrin, and bone morphogenetic protein-2, seem promising in UTI diagnosis, while other biomarkers failed to show any utility. Whereas a single biomarker was not enough, a combination of biomarkers could have more chances to help in the diagnosis.

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The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis

Cited by 24 publications

References 26 publications

Diagnostic value of mid-regional pro-Adrenomedullin as a biomarker of invasive bacterial infection in children: a systematic review

Diagnostic value of mid-regional pro-Adrenomedullin as a biomarker of invasive bacterial infection in children: a systematic review

The Interplay between Host Defense, Infection, and Clinical Status in Septic Patients: A Narrative Review

Asymptomatic Bacteriuria or Urinary Tract Infection? New and Old Biomarkers

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