Abstract
Background: The inflammatory response in community-acquired pneumonia (CAP) depends on the host response, causal microorganism and severity of infection.
Objective: To analyze in a prospective study the pattern of inflammatory cytokines and biomarkers PCT and CRP (procalcitonin and C-reactive protein) in bacteriemic CAP in hospitalized CAP patients.
Results: 685 patients were included: 40 of them with bacteremia. The medians of CRP, PCT, TNF and IL-6 were significantly higher in those with bacteriemia (Table 1). PCT ≥0.36 to predict positive blood cultures showed sensitivity (S) of 85%, specificity (E) 42% and negative predictive value (NPV) of 98% (ROC area 0.70). The threshold of IL-6 ≥ 150 for predicting bacteremic CAP showed: 60% sensitivity, 70% and 96% negative predictive value (ROC area 0.65).
Biomarkers and citokines in CAP
Conclusions: Bacteriemic CAP is associated with higher inflammatory cytokine systemic. PCT showed the highest diagnostic value. A cutoff ≥0.36 has high sensitivity. Lower initial PCT levels rule out bacteriemic CAP with a high negative predictive value.
- © 2011 ERS
