- Pulmonary critical care
- Open Access
Evaluation of serum-soluble triggering receptor expressed on myeloid cells-1 as a novel marker in the diagnosis of ventilator-associated pneumonia in adults
Egyptian Journal of Bronchology volume 9, pages 261–268 (2015)
Ventilator-associated pneumonia (VAP) remains the most common nosocomial infection in ICUs. VAP occurs in 10–20% of patients who are mechanically ventilated for more than 48 h. The interval between diagnosis and the availability of microbiological results is the period when clinicians would most benefit from a reliable biomarker that could provide an early indication of poor response. Serum-soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) belongs to the immunoglobin superfamily, and it has the advantage of being increased during infectious processes but not in noninfectious inflammatory conditions. The aim of this study was to assess the value of serum level of sTREM-1 as a diagnostic biomarker for VAP in comparison with commonly used indicators, including procalcitonin (PCT) and C-reactive protein (CRP). This study was carried out on 60 participants. They were divided into two groups: group I included 30 adult patients with clinically suspected VAP, and group II included 30 ICU ventilated patients of the same age group without VAP and free of other infectious diseases who served as the control group. They were selected from the ICUs of Chest and other Departments, Tanta University Hospitals, during the period from January 2014 until September 2014. The present study revealed that serum level of sTREM-1 was significantly higher in patients with VAP in comparison with the control group. It was also concluded that serum level of sTREM-1 was significantly higher in VAP patients with bacterial growth culture results than in VAP patients with no growth culture results. A diagnostic cutoff value greater than 110 pg/ml with a sensitivity of 87.5%, specificity of 83.3%, positive predictive value of 95.5%, and negative predictive value of 62.5% of serum sTREM-1 level could discriminate positive culture results from negative culture results in VAP patients, which were higher than that of serum levels of PCT and CRP. It was concluded that serum level of sTREM-1 was significantly higher in VAP patients in comparison with non-VAP patients and it showed the highest sensitivity and specificity (87.5 and 83.3%, respectively) in differentiating between VAP patients with bacterial growth culture results and VAP patients with no growth culture results compared with PCT and CRP levels, thus rendering serum level of sTREM-1 a novel diagnostic marker for VAP. Egypt J Broncho 2015 9:261–268 © 2015 Egyptian Journal of Bronchology.
Charles MVP, Kali A, Easow JM, Joseph NM, et al. Ventilator-associated pneumonia. AMJ 2014; 7:334–344.
Zielińska-Borkowska U, Skirecki T, Złotorowicz M, et al. Procalcitonin in early onset ventilator-associated pneumonia. J Hosp Infect 2012; 3:92–97.
Park DR, Park DR, Park DR. Antimicrobial treatment of ventilator-associated pneumonia. Respir Care 2005; 50:932–932952; discussion 952–955.
Harde Y, Rao SM, Sahoo JN, et al. Detection of ventilator associated pneumonia, using clinical pulmonary infection score (CPIS) in critically ill neurological patients. JOACP 2013; 2:20.
Palazzo SJ, Simpson T, Schnapp L. Biomarkers for ventilator-associated pneumonia: review of the literature. Heart Lung 2011; 40:293–298.
Rea-Neto A, Youssef NC, Tuche F, Brunkhorst F, Ranieri VM, Reinhart K, Sakr Y. Diagnosis of ventilator-associated pneumonia: a systematic review of the literature. Crit Care 2008; 12:R56.
Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Critical Care 2010; 14:R15.
Oppert M, Reinicke A, Müller C, et al. Elevations in procal-citonin but not C-reactive protein are associated with pneumonia after cardiopulmonary resuscitation. Resuscitation 2002; 53:167–170.
Determann RM, Millo JL, Gibot S, Korevaar JC, Vroom MB, van der Poll T, et al. Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia. Intensive Care Med 2005; 31:1495–1500.
Summah H, Qu JM. Biomarkers: a definitive plus in pneumonia. Mediators Inflamm 2009; 67:53–57.
Henriquez-Camacho C, Losa J. Biomarkers for sepsis. Bio Med Res Int 2014; 2014:1–6.
Cho SY, Choi JH. Biomarkers of sepsis. Infect Chemother 2014; 46:1–12.
Kibe S, Adams K, Barlow G. Diagnostic and prognostic biomarkers of sepsis in critical care. J Antimicrob Chemother 2011; 66: Suppl 2:ii33–ii33ii40.
Charles MVP, JM Easow, Joseph NM, et al. Incidence and risk factors of ventilator associated pneumonia in a tertiary care hospital. AMJ 2013; 6:178–182.
Lee MS, Walker V, Chen LF, Sexton DJ, Anderson DJ. The epidemiology of ventilator-associated pneumonia in a network of community hospitals: a prospective multicenter study. Infect Control Hosp Epidemiol 2013; 34:657–662.
Linssen CF, Bekers O, Drent M, Jacobs JA. C-reactive protein and procalcitonin concentrations in bronchoalveolar lavage fluid as a predictor of ventilator-associated pneumonia. Ann Clin Biochem 2008; 45(Pt 3):293–298.
Povoa P, Coelho L, Almeida E, Fernandes A, Mealha R, Moreira P, Sabino H. C-reactive protein as a marker of ventilator-associated pneumonia resolution: a pilot study. Eur Respir J 2005; 25:804–812.
Duflo F, Debon R, Monneret G, Bienvenu J, Chassard D, Allaouchiche B. Alveolar and serum procalcitonin: diagnostic and prognostic value in ventilator-associated pneumonia. Anesthesiology 2002; 96:74–79.
Gilbert DN. Procalcitonin as a biomarker in respiratory tract infection. Clin Infect Dis 2011; 52: Suppl 4:S346–S346S350.
Phua J, Koay ES, Zhang D, Tai LK, Boo XL, Lim KC, Lim TK. Soluble triggering receptor expressed on myeloid cells-1 in acute respiratory infections. Eur Respir J 2006; 28:695–702.
Rivera-Chavez FA, Minei JP. Soluble triggering receptor expressed on myeloid cells-1 is an early marker of infection in the surgical intensive care unit. Surg Infect (Larchmt) 2009; 10:435–439.
Delèvaux I, André M, Colombier M, Albuisson E, Meylheuc F, Bègue RJ, et al. Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of infammatory processes? Ann Rheum Dis 2003; 62:337–340.
Ramirez P, Garcia MA, Ferrer M, Aznar J, Valencia M, Sahuquillo JM, et al. Sequential measurements of procalcitonin levels in diagnosing ventilator-associated pneumonia. Eur Respir J 2008; 31:356–362.
Porfyridis I, Plachouras D, Karagianni V, Kotanidou A, Papiris SA, Giamarellou H, Giamarellos-Bourboulis EJ. Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study. BMC Infect Dis 2010; 10:286.
Refaat A, Affara N, Abdel-fatah W, et al. Diagnostic accuracy of inflammatory biomarkers in bronchoalveolar lavage from patients with ventilator-associated pneumonia. EJCDT 2014; 63:723–730.
Menéndez R, Sahuquillo-Arce JM, Reyes S, Martinez R, Polverino E, Cillóniz C, et al. Cytokine activation patterns and biomarkers are influenced by microorganisms in community-acquired pneumonia. Chest 2012; 141:1537–1545.
Schuetz P, Affolter B, Hunziker S, Winterhalder C, Fischer M, Balestra GM, et al. Serum procalcitonin, C-reactive protein and white blood cell levels following hypothermia after cardiac arrest: a retrospective cohort study. Eur J Clin Invest 2010; 40:376–381.
Huh JW, Lim CM, Koh Y, Oh YM, Shim TS, Lee SD, et al. Diagnostic utility of the soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid from patients with bilateral lung infiltrates. Crit Care 2008; 12:R6.
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Mohamed, W.M., Ramadan, M.O., Attia, G.A. et al. Evaluation of serum-soluble triggering receptor expressed on myeloid cells-1 as a novel marker in the diagnosis of ventilator-associated pneumonia in adults. Egypt J Bronchol 9, 261–268 (2015). https://doi.org/10.4103/1687-8426.165907
- serum-soluble triggering receptor expressed on myeloid cells-1
- ventilator-associated pneumonia