RT Journal Article
SR Electronic
T1 Diagnostic accuracy of inflammatory biomarkers in bronchoalveolar lavage from patients with ventilator-associated pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2538
VO 44
IS Suppl 58
A1 Nasr Affara
A1 Alaa Refaat
A1 Tamer Hussein
A1 Waleed Abdelfatah
A1 Manal Elberbi
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2538.abstract
AB Background: The clinical diagnosis of ventilator-associated pneumonia is difficult. Many biological markers have been studied in an effort to improve the rapidity of current diagnostic procedures in VAP. So, this study was done to determine the discriminative power of single or combining multiple biomarkers in BAL including soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), Soluble urokinase plasminogen activator receptor (suPAR), andMacrophage migration inhibitory factor (MIF) for the diagnosis of bacterial VAP among patients who were receiving mechanical ventilation. Patients and Methods: The study was conducted in the intensive care units of Chest, Internal Medicine and Anesthesia Departments, Zagazig University Hospitals, Egypt, between January and December 2012, 66 adult patients were included. Results The AUCs for discrimination between infection of bacterial origin and no infection were 0.83 for CRP, 0.77 for PCT, 0.72 for neutrophils, 0.60 for MIF, 0.68 for sTREM-1 and 0.51 for suPAR, 0.86 for the composite three-marker test (CRP, PCT, and neutrophils), and 0.90 for the composite six-marker test. The six-marker test performed significantly better than all of the single markers (P < 0.05 for three-marker test and CRP and P < 0.001 for the five remaining markers). Conclusions: Single measurement of biomarker concentration in the BAL of mechanically-ventilated patients with new or progressive infiltrates not enhance identification of VAP. However, combining results from several inflammatory markers may significantly improve ability to differentiate bacterial from nonbacterial infections.