Predictive value of soluble urokinase plasminogen activator receptor in late-onset sepsis in newborn

Abstract

Objective To investigate the dynamic changes of soluble urokinase-type plasminogen activator receptor (suPAR) and its predictive value in late-onset sepsis in the newborn. Method To collect the data of neonates aged 7 days and older, who were diagonsed to have infections. They were admitted to neonatal intensive care unit of our Hospital from January 2014 to January 2015. The group of sepsis and non-septic group were assigned according to the diagnostic criteria of sepsis, and a control group was selected without infection. Blood cultures were collected in patients on the first day when infection was identified and the serum suPAR and CRP were measured on the first day, fourth day and tenth day respectively. The controls were tested with suPAR and CRP when infection was excluded. The levels of blood suPAR and CRP in the three groups were compared and the receiver-operating characteristic curve was performed according to serum suPAR level of neonates with sepsis on the first day. Result A total of 65 infants with infections (40 were septic and 25 were non-septic) were enrolled in this study and 20 patients were selected as control group. There were significant differences in serum suPAR and CRP levels between the patients with and without infection (P 0.05). There were no deaths in the sepsis group and the non-septic group, but the levels of suPAR between survivals and deaths in the infection groups were statistically significant [15.4(10.6, 21.6) ng/ml vs. 22.6 (15.4, 31.9) ng/ml, Z=-2.063, P=0.039]. The area under the receiver-operating characteristic curve of serum suPAR was 0.955 (95% CI 0.906~1.000, P<0.001), and the sensitivity was 90% and the specificity was 100% when the suPAR level was 10.9 ng/ml. Conclusion Early elevated serum suPAR levels were prominently related to the severity of neonatal late-onset sepsis. The level of first day suPAR has a high sensitivity and specificity in the prognosis of sepsis and can be helpful to predict the prognosis. Key words: Receptors, urokinase plasminogen activator; C-reactive protein; late onset sepsis; Infant, newborn