Diagnostic value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for late-onset neonatal sepsis in infected preterm neonates

• Published in: Journal of international medical research 2018-04, Vol.46 (4), p.1606-1616
• Main Authors: Alkan Ozdemir, Senem, Ozer, Esra Arun, Ilhan, Ozkan, Sutcuoglu, Sumer, Tatlı, Mansur
• Format: Article
• Language: English
• Subjects: Age of Onset; Clinical Reports; Female; Humans; Infant, Newborn; Male; Neonatal Sepsis - diagnosis; Neonatal Sepsis - urine; Newborn babies; Premature Birth - urine; ROC Curve; Sensitivity and Specificity; Sepsis; Solubility; Triggering Receptor Expressed on Myeloid Cells-1 - metabolism; Urine
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060517749131

Objective Sepsis is a complex clinical condition caused by a dysregulated immune response to an infection resulting in a fatal outcome. This study aimed to investigate the value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for diagnosing culture-proven sepsis in preterm infants. Methods Preterm neonates were evaluated for late-onset sepsis (LOS). Laboratory investigations were performed. Urine sTREM-1 samples and blood cultures were synchronously collected. Using blood culture results, preterm neonates were divided into the culture-proven group and suspected sepsis group. Results A total of preterm 62 infants were included in the study; 31 had culture-proven sepsis and 31 were suspected as having sepsis. There were no significant differences in gestational age, sex, birth weight, and delivery mode between the groups. Neonates in the culture-proven group had significantly higher urine sTREM-1 levels than did those in the suspected sepsis group. Using a cut-off point for a urine sTREM-1 level of 78.5 pg/mL, the sensitivity was 0.90, specificity was 0.78, positive predictive value was 0.68, and negative predictive value was 0.94. Conclusions The present study highlights the role of urine sTREM-1 levels in LOS. Urine sTREM-1 may be a reliable and sensitive marker in detecting sepsis in preterm infants.