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BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Biomarkers of endothelial dysfunction predict sepsis mortality in young infants: a matched case-control study

Authors: Julie Korol Wright, Kyla Hayford, Vanessa Tran, Gulam Muhammed Al Kibria, Abdullah Baqui, Ali Manajjir, Arif Mahmud, Nazma Begum, Mashuk Siddiquee, Kevin C. Kain, Azadeh Farzin

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Reducing death due to neonatal sepsis is a global health priority, however there are limited tools to facilitate early recognition and treatment. We hypothesized that measuring circulating biomarkers of endothelial function and integrity (i.e. Angiopoietin-Tie2 axis) would identify young infants with sepsis and predict their clinical outcome.

Methods

We conducted a matched case-control (1:3) study of 98 young infants aged 0–59 days of life presenting to a referral hospital in Bangladesh with suspected sepsis. Plasma levels of Ang-1, Ang-2, sICAM-1, and sVCAM-1 concentrations were measured at admission. The primary outcome was mortality (n = 18); the secondary outcome was bacteremia (n = 10).

Results

Ang-2 concentrations at presentation were higher among infants who subsequently died of sepsis compared to survivors (aOR 2.50, p = 0.024). Compared to surviving control infants, the Ang-2:Ang-1 ratio was higher among infants who died (aOR 2.29, p = 0.016) and in infants with bacteremia (aOR 5.72, p = 0.041), and there was an increased odds of death across Ang-2:Ang-1 ratio tertiles (aOR 4.82, p = 0.013).

Conclusions

This study provides new evidence linking the Angiopoietin-Tie2 pathway with mortality and bacteremia in young infants with suspected sepsis. If validated in additional studies, markers of the angiopoietin-Tie2 axis may have clinical utility in risk stratification of infants with suspected sepsis.
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Metadata
Title
Biomarkers of endothelial dysfunction predict sepsis mortality in young infants: a matched case-control study
Authors
Julie Korol Wright
Kyla Hayford
Vanessa Tran
Gulam Muhammed Al Kibria
Abdullah Baqui
Ali Manajjir
Arif Mahmud
Nazma Begum
Mashuk Siddiquee
Kevin C. Kain
Azadeh Farzin
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1087-x

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