The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants

Objective: To assess the accuracy of lipopolysaccharide binding protein (LBP) for diagnosing late-onset neonatal sepsis (LONS) in very low birth weight (VLBW) infants. Study design: Observational, prospective study. We assessed the diagnostic performance of LBP in 26 suspected LONS episodes among 54 patients. Proven and probable LONS episodes were recorded according to established criteria. Receiver operating characteristic curve analysis was performed to evaluate LBP's ability to predict LONS. Results: LONS was diagnosed in 17 of 26 episodes. LBP levels were significantly higher in confirmed LONS episodes (P < 0.001). The area under the curve of LBP was 0.89. A cut-off of 17.5 mu g/mL had a sensitivity of 94.1%, a specificity of 77.8%, a positive predictive value of 88.9% and a negative predictive value of 87.5%. Conclusions: Serum LBP measurement may be useful as an additional tool in the evaluation of suspected LONS in VLBW infants.