A diagnostic test: combined detection of heparin-binding protein, procalcitonin, and C-reactive protein to improve the diagnostic accuracy of bacterial respiratory tract infections

Abstract

Background: Respiratory tract infection (RTI) is one of the most common diseases worldwide, and its incidence is rising year by year due to environmental pollution. Sputum culture remains the gold standard for RTI diagnosis, but its performance is limited by difficulties related to the sampling and testing of the sputum specimens. Heparin-binding protein (HBP), procalcitonin (PCT), and C-reaction protein (CRP) are Inflammatory markers. They have the advantage of being fast, accurate and reproducible, but limited by their sensitivity and specificity. We explored the clinical value of the combined detection of them in the diagnosis of bacterial RTIs.Methods: Patients who fulfilled the inclusion criteria were selected as the case group, healthy age-and sexmatched subjects were enrolled as a control group. The subjects' HBP, PCT, and CRP levels were detected.The case group was further divided into two groups according to the bacterial culture results, and the differences in the markers were statistically analyzed. The receiver operating characteristic (ROC) curves were drawn, and the areas under the ROC curve (AUCs) were calculated to analyze the diagnostic values of each marker and their combination in parallel for bacterial RTIs. Results:The plasma HBP, PCT, and CRP levels of patients in the bacterial and non-bacterial infection groups were significantly higher than those of patients in the healthy control group, and were positively correlated to the severity of the disease. for HBP with an AUC of 0.785 [95% confidence interval (CI): 0.686-0.884], a sensitivity of 0.821, a specificity of 0.771; PCT with an AUC of 0.767 (95% CI: 0.664-0.870), a sensitivity of 0.773, a specificity of 0.791, and CRP with an AUC of 0.748 (95% CI: 0.642-0.854), a sensitivity of 0.839, a specificity of 0.696 in the bacterial and non-bacterial infection groups. The combined detection of HBP + CRP had the optimal diagnostic performance, with an AUC of 0.797 (95% CI: 0.698-0.895; P<0.001), a sensitivity of 0.809, a specificity of 0.800. Conclusions:The combined detection of HBP and CRP is valuable for diagnosing bacterial RTIs and may guide the development of reasonable treatment protocols in clinical settings.

The predictive value of heparin-binding protein for bacterial infections in patients with severe multiple trauma

“…The HL test and Calibration curve results show that the multivariable logistic regression model has good fit and predictive ability. Our findings on the predictive value of HBP combined with other inflammatory indicators agree with those reported by Jin Ma et al, who discovered that adding HBP to other inflammatory markers enhanced prediction accuracy[19]. Furthermore, ROC analysis confirmed that the predictive value of the logistic regression model was superior to that of HBP alone, showing that HBP can be used as a better complementary indicator to existing inflammatory indicators.…”

Heparin-Binding Protein: A Prognostic Biomarker Associated with Severe or Complicated Community-Acquired Pneumonia in Children

“…Previous findings have revealed that HBP is a marker of bacterial infection in adult patients. 27 , 28 However, a relatively small proportion of enrolled patients were diagnosed with bacterial infections in this study, and no patient was found to have positive blood culture. Therefore, we prespecified a sensitivity analysis excluding patients with bacterial infections.…”

The diagnostic utility of heparin-binding protein among patients with bacterial infections: a systematic review and meta-analysis

“… 34 Linder 2011 [ 25 ] Prospective and retrospective multicenter cohort study Sweden 77 Inclusion criteria: patients with clinically suspected meningitis, who underwent a lumbar puncture March 2006 to November 2009 Lund University Hospital, Lund, Sweden NA CSF Diagnosis was based on classification of bacterial meningitis was based on the criteria of Durand. 20 Ma 2022 [ 14 ] Prospective case control study China 87 Inclusion criteria: (I) inpatient with complete clinical data at the Department of Respiratory Medicine of our hospital; (II) be aged ≥18 years; (III) for the case group, meet the diagnostic criteria for respiratory tract bacterial infection January 2019 to December 2019 Department of Respiratory Medicine of the East Hospital of Sichuan Provincial People’s Hospital On hospital admission Blood Diagnosis was based on RTI on the definition and diagnostic criteria for RTI set out in the Guidelines for the Diagnosis and Treatment of Respiratory Diseases. 24.17 Namiduru 2022 [ 11 ] Prospective study India 97 Inclusion criteria: Patients with meningitis admitted to University of Gaziantep Medicine Faculty Hospital.…”

“…Moreover, elevated urinary HBP was significantly associated with the presence of urinary tract infections (UTI) in adults and children [ 12 , 13 ]. It was also reported to be of diagnostic value in respiratory tract infections (RTI) [ 14 ].…”