TY - JOUR T1 - Respiratory pathogens, immunodeficiency or systemic response - What comes first in the etiology of severe community-acquired pneumonia (sCAP) JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2699 AU - Kseniia Bielosludtseva AU - Tetyana Kireeva Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2699.abstract N2 - Aim: to study the diagnostic value of CD4 marker and procalcitonin (PCT) at patients with sCAP in connection with the respiratory pathogen.Materials and methods: we studied 32 patients (pts) with sCAP and identified respiratory pathogen: physical examination, identification of agent, HIV-test, CD4 counting, the study of PCT level on 1st day before antibiotic therapy.Results: depending on the etiology of sCAP patients were retrospectively divided into 2 groups: group 1 - 24 HIV-negative pts, who were divided into 2 subgroups: 1A - 15 pts with Gr+bacteria, 1B - 9 patients with Gr-bacteria, group 2 - 8 HIV-positive pts with Pneumocystis pneumonia.View this table:Levels of CD4 and PCT in groups and subgroupsPts of group 1 had strong inverse correlation between CD4 and PCT (r =-0,73, p < 0,05) in contrast with group 2.Conclusions: 1)decreasing of CD4 at HIV-negative patients less than 500 ml-1 significantly increases the risk of sCAP causing Gr- agents, which, in turn, is accompanied with severe systemic inflammatory response; 2) for Pneumocystis pneumonia at HIV-positive patients do not observe correlation between CD4 and system response. ER -