Objective Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been suggested as a useful marker in limited recent studies for diagnosis of sepsis in pediatric and adult patients. We aimed to determine the value of uNGAL levels in early diagnosis of late-onset sepsis in preterms, and to compare CRP and PCT.
Materials and Methods Between February - May 2011, preterm infants admitted to NICU between the ages of 7 to 28 days divided into two groups: 24 cases with clinical sepsis (gestational age 32.88±1.45w) and 20 cases as control group (gestational age 33±1.49w).
Results There is no difference in two groups in terms of demographic features of babies. At 1. and 7. days of treatment in sepsis group, CRP (median:25.09mg/Lvs8.63mg/L),
PCT (median; 17.11ng/mlvs1.39ng/ml)and uNGAL levels were found 45.69±18.37ng/ml, 7.89±4.19ng/ml respectively. In control group, uNGAL levels were found 5.78±1.6ng/ml. We found significant differences CRP, PCT and uNGAL levels between groups. On the seventh day of treatment, CRP, PCT and uNGAL levels significantly decreased.
We found that the sensitivity, specificity, positive and negative predictive values, respectively: for CRP; 58.3%, 80%, 77.8% and 61.5%, for PCT; 91.7%, 75%, 81.5% and 88.2%, for uNGAL; 91.7%, 100%, 100% and 90.9%.
Conclusion Urinary NGAL seems to be more sensitive and spesific, reliable biomarker than serum CRP and PCT. We believe that uNGAL unlike other biomarkers that does not require a blood sample, non-invasive and non-sterile conditions, with small amounts of urine collection in newborn sepsis might be an ideal biomarker.