Author:
Tan Toh Leong,Kang Christabel Wan-li,Ooi Kai Shen,Tan Swee Thian,Ahmad Nurul Saadah,Nasuruddin Dian Nasriana,Ithnin Azlin,Tajul Arifin Khaizurin,Heng Lee Yook,Hassan Nurul Izzaty,Gan Kok Beng,Neoh Hui-min
Abstract
AbstractEarly bacterial infection (BI) identification in resource-limiting Emergency Departments (ED) is challenging, especially in low- and middle-income counties (LMIC). Misdiagnosis predisposes to antibiotic overuse and propagates antimicrobial resistance. This study evaluates new emerging biomarkers, secretory phospholipase A2 group IIA (sPLA2-IIA) and compares with other biomarkers on their performance characteristic of BI detection in Malaysia, an LMIC. A prospective cohort study was conducted involving 151 consecutive patients admitted to the ED. A single measurement was taken upon patient arrival in ED and was analysed for serum levels of sPLA2-IIA, high-sensitive C-reactive protein (CRP), procalcitonin (PCT), neutrophil percentage (N%), and lactate. All biomarkers’ performance was compared for the outcomes using area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The performance of sPLA2-IIA (AUROC 0.93 [95% CI: 0.89–0.97]; Sn 80% [95% CI: 72–87]; Sp 94% [95% CI: 81–89]) was the highest among all. It was comparable with high-sensitive CRP (AUROC 0.93 [95% CI: 0.88–0.97]; Sn 75% [95% CI: 66–83]; Sp 91 [95% CI: 77–98]) but had a higher Sn and Sp. The sPLA2-IIA was also found superior to N%, PCT, and lactate. This finding suggested sPLA2-IIA was recommended biomarkers for BI detection in LMIC.
Funder
Ministry of Education, Malaysia
Universiti Kebangsaan Malaysia, Malaysia
Publisher
Springer Science and Business Media LLC
Reference44 articles.
1. Wang, H. et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388, 1459–1544. https://doi.org/10.1016/S0140-6736(16)31012-1 (2016).
2. Dadonaite, B. and Roser, M. Pneumonia. OurWorldInData.org. https://ourworldindata.org/pneumonia (2018)
3. Aston, S. J. Pneumonia in the developing world: characteristic features and approach to management. Respirology 22, 1276–1287. https://doi.org/10.1111/resp.13112 (2017).
4. Zar, H. J., Madhi, S. A., Aston, S. J. & Gordon, S. B. Pneumonia in low and middle income countries: progress and challenges. Thorax 68, 1052–1056. https://doi.org/10.1136/thoraxjnl-2013-204247 (2013).
5. Ab. Razak, M.Y. Statistic on Causes of Death, Malaysia, 2020. Department of Statistics Malaysia Official Portal. https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=401&bul_id=QTU5T0dKQ1g4MHYxd3ZpMzhEMzdRdz09&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09 (2020)
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