TY - JOUR
T1 - The Diagnostic Value of Human Neutrophilic Peptides 1-3 in Acute Pediatric Febrile Illness
AU - Kassem, Eiass
AU - Shapira, Maanit
AU - Sussan, Miral
AU - Mahamid, Loay
AU - Amsalem, Naama
AU - Abu Fanne, Rami
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/10/13
Y1 - 2023/10/13
N2 - Background: It is prudent to develop biomarkers that enhance the differentiation between viral and bacterial infection in order to support expeditious and judicious antimicrobial implementation in emergency department admissions. Human neutrophilic peptides 1-3 (HNP1-3) are the major neutrophilic peptides with potent antimicrobial activity. Methods: We tested the performance of the plasma HNP1-3 test in a prospective observational cohort of children admitted to the emergency department for fever. We validated this test with traditionally used biomarkers and final diagnoses. An expert panel reviewed the patient’s data and gave a final diagnosis. The final diagnosis was classified as definite, probable, or possible. Results: A total of 111 children (98 with fever and 13 control) were recruited: 55% male, mean age 6.3 years. Plasma HNP1-3 levels were higher with bacterial infections: 10,428 (5789–14,866) vs. 7352 (3762–10,672) pg/mL, p = 0.007. HNP1-3 were negatively correlated with age: r = −0.207, p = 0.029. Of the different categorical variables tested, only c-reactive protein (CRP) (≥42.3 mg/dL), neutrophil count (≥10.2), and age (odds ratio = 1.185, p = 0.013 and 95%CI = 1.037–1.354) had significant diagnostic capability for bacterial disease prediction. Conclusions: Due to its low diagnostic value in febrile patients, the HNP1-3 value is not currently recommended to support pathogen differentiation in children in an emergency setting. Further studies are needed to support its clinical use.
AB - Background: It is prudent to develop biomarkers that enhance the differentiation between viral and bacterial infection in order to support expeditious and judicious antimicrobial implementation in emergency department admissions. Human neutrophilic peptides 1-3 (HNP1-3) are the major neutrophilic peptides with potent antimicrobial activity. Methods: We tested the performance of the plasma HNP1-3 test in a prospective observational cohort of children admitted to the emergency department for fever. We validated this test with traditionally used biomarkers and final diagnoses. An expert panel reviewed the patient’s data and gave a final diagnosis. The final diagnosis was classified as definite, probable, or possible. Results: A total of 111 children (98 with fever and 13 control) were recruited: 55% male, mean age 6.3 years. Plasma HNP1-3 levels were higher with bacterial infections: 10,428 (5789–14,866) vs. 7352 (3762–10,672) pg/mL, p = 0.007. HNP1-3 were negatively correlated with age: r = −0.207, p = 0.029. Of the different categorical variables tested, only c-reactive protein (CRP) (≥42.3 mg/dL), neutrophil count (≥10.2), and age (odds ratio = 1.185, p = 0.013 and 95%CI = 1.037–1.354) had significant diagnostic capability for bacterial disease prediction. Conclusions: Due to its low diagnostic value in febrile patients, the HNP1-3 value is not currently recommended to support pathogen differentiation in children in an emergency setting. Further studies are needed to support its clinical use.
KW - fever
KW - misdiagnosis
KW - neutrophilic peptide 1-3
KW - viral
UR - http://www.scopus.com/inward/record.url?scp=85175183962&partnerID=8YFLogxK
U2 - 10.3390/jcm12206514
DO - 10.3390/jcm12206514
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C2 - 37892652
AN - SCOPUS:85175183962
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 20
M1 - 6514
ER -