Potential Diagnostic Value of Serum Amyloid-A in Preterm Neonates with Late-onset Sepsis. A Prospective Case-Control Study

Document Type : Research article


1 Pediatric department, faculty of Medicine, Minia University, Egypt

2 Clinical-Pathology department, faculty of Medicine, Minia University, Egypt


Background: Neonatal sepsis is a serious infection that continues to puzzle neonatologists with its variable presentation, with great difficulty in distinguishing it from other diseases or even normal birth processes. Discrimination of neonatal sepsis depends mainly on investigations. Blood culture is the cornerstone of the investigations. Several biomarkers are used to provide early diagnosis and follow-up. SAA is a promising biomarker among the available ones.
Objective: To evaluate the utility of serum Amyloid-A (SAA) in diagnosis of late-onset sepsis (LOS) in preterm neonates.
Methods: This is a prospective case-control study that was conducted on 46 preterm neonates; 23 cases with neonatal sepsis and 23 healthy age and sex-matched control group. The septic group presented with neonatal sepsis diagnosed clinically and laboratory using blood cultures, complete blood count, and serum C-reactive protein (CRP). The optimal cut-off level of SAA was determined by receiver-operating characteristics curve (ROC) analysis.
Results Forty-six neonates (33.78±1.7 weeks) were evaluated "23 as cases and 23 as control". The level of SSA in the septic group was significantly higher compared to the control group with P= <0.001. The sensitivity, specificity, PPV, and NPV of serum Amyloid-A for the detection of sepsis were 100%, 95%, 100%, and 95% respectively at a cut-off of 7.6 μg/ml.
Conclusion: Serum Amyloid-A ( SAA) can be used as a valuable biomarker for diagnosing late-onset sepsis in preterm neonates.


Main Subjects