%0 Journal Article
%T Novel biomarker combination improves the diagnosis of serious bacterial infections in Malawian children
%A Adam D Irwin
%A Fiona Marriage
%A Limangeni A Mankhambo
%A IPD Study Group
%A Graham Jeffers
%A Ruwanthi Kolamunnage-Dona
%A Malcolm Guiver
%A Brigitte Denis
%A Elizabeth M Molyneux
%A Malcolm E Molyneux
%A Philip J Day
%A Enitan D Carrol
%J BMC Medical Genomics
%D 2012
%I BioMed Central
%R 10.1186/1755-8794-5-13
%X We identified three previously reported biomarkers of infection (neutrophil gelatinase-associated lipocalin (NGAL), granulysin and resistin) and measured gene expression using quantitative real-time PCR. Protein products related to the three transcripts were measured by immunoassays.Relative gene expression values of NGAL and resistin were significantly increased, and expression of granulysin significantly decreased in cases compared to controls. Plasma concentrations of NGAL and resistin were significantly increased in children with confirmed SBI compared to children with no detectable bacterial infection (NBI), and to controls (287 versus 128 versus 62 ng/ml and 195 versus 90 versus 18 ng/ml, respectively, p£¿<£¿0.05). Plasma protein concentrations of NGAL and resistin were significantly increased in non-survivors compared to survivors (306 versus 211 and 214 versus 150 ng/ml, p£¿=£¿0.02). The respective areas under the curve (AUC) for NGAL, resistin and procalcitonin in predicting SBI were 0.79, 0.80 and 0.86, whilst a combination of NGAL, resistin and procalcitonin achieved an AUC of 0.90.We have demonstrated a unique combination of diagnostic biomarkers of SBI using transcriptomics, and demonstrated translational concordance with the corresponding protein. The addition of NGAL and resistin protein measurement to procalcitonin significantly improved the diagnosis of SBI.
%K Biomarker
%K Bacterial infection
%K Transcriptomics
%K Diagnosis
%K Protein
%K Biology
%K Procalcitonin
%K Resistin
%K Neutrophil-associated gelatinase
%U http://www.biomedcentral.com/1755-8794/5/13/abstract