Pentraxin 3 as an early marker in diagnosis of ventilator associated pneumonia

El-Mahalawy, Ibrahim I.; Ammar, Amany S; Fathy, Waleed M; Salama, Asmaa E

doi:10.1016/j.ejcdt.2017.10.004

Cited by 3 publications

(5 citation statements)

References 10 publications

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“…The results of the quality assessment reviews conducted using the form adopted from CASP diagnostic study checklist showed that five papers [ 51 , 54 , 57 , 62 , 82 ] suffered from verification bias: not all patients received testing by both the index and the reference standard. In 38 papers [ 41 – 47 , 49 – 53 , 55 – 59 , 61 – 68 , 70 , 71 , 73 – 82 ], the results of the index test could have been influenced by the reference standard result. This means that there was no evidence blinding or the tests being performed independently.…”

Section: Resultsmentioning

confidence: 99%

“…Forty-three of the studies were cohort studies (38 of which were prospective studies) and one was a secondary analysis of data from a randomised controlled trial (RCT) [ 57 ]. All studies were published between 2008 and 2018 with a wide geographical spread; four studies conducted in the UK [ 41 , 44 , 72 , 74 ], eight in the USA [ 40 , 45 , 47 , 50 , 56 , 62 , 67 , 75 ], seven in France [ 51 , 53 , 55 , 63 , 70 , 73 , 78 ], five in Netherland [ 48 , 61 , 66 , 77 , 79 ], three each in both China [ 52 , 65 , 68 ] and Turkey [ 43 , 46 , 82 ], two each in Egypt [ 49 , 76 ], Brazil [ 54 , 81 ], and Italy [ 71 , 83 ], and eight in other countries [ 42 , 57 – 60 , 64 , 69 , 80 ]. The median sample size was 180 recruited participants, with the 21 being the lowest [ 58 ] and 2080 being the highest number of participants [ 61 ] (see Tables 2 , 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…One of these studies did not define which of the studied tests were considered index and which were considered reference [ 54 ]. Of the remaining 31 studies, culture of BAL fluid was most commonly used as the reference test, forming at least part of the reference standard in 26 (83.8%) studies [ 40 , 41 , 43 , 45 , 48 , 49 , 51 , 55 – 60 , 63 , 65 – 67 , 69 , 70 , 73 – 77 , 79 , 82 ]. BAL culture alone was the sole reference standard in 18 (58.1%) out of the 31 studies [ 40 , 41 , 43 , 45 , 49 , 55 , 56 , 58 , 60 , 63 , 65 , 69 , 70 , 73 – 76 , 82 ].…”

Section: Reference Standardmentioning

confidence: 99%

“…Of the remaining 31 studies, culture of BAL fluid was most commonly used as the reference test, forming at least part of the reference standard in 26 (83.8%) studies [ 40 , 41 , 43 , 45 , 48 , 49 , 51 , 55 – 60 , 63 , 65 – 67 , 69 , 70 , 73 – 77 , 79 , 82 ]. BAL culture alone was the sole reference standard in 18 (58.1%) out of the 31 studies [ 40 , 41 , 43 , 45 , 49 , 55 , 56 , 58 , 60 , 63 , 65 , 69 , 70 , 73 – 76 , 82 ]. Where used, the BAL culture threshold for positivity included > 10 CFU/mL [ 76 ], > 10 3 CFU/mL [ 56 ], > 10 4 CFU/mL [ 40 , 41 , 43 , 49 , 55 , 58 , 60 , 63 , 65 , 69 , 70 , 73 – 75 , 82 ], and > 10 5 CFU/mL [ 45 ].…”

Section: Reference Standardmentioning

confidence: 99%

“…BAL culture alone was the sole reference standard in 18 (58.1%) out of the 31 studies [ 40 , 41 , 43 , 45 , 49 , 55 , 56 , 58 , 60 , 63 , 65 , 69 , 70 , 73 – 76 , 82 ]. Where used, the BAL culture threshold for positivity included > 10 CFU/mL [ 76 ], > 10 3 CFU/mL [ 56 ], > 10 4 CFU/mL [ 40 , 41 , 43 , 49 , 55 , 58 , 60 , 63 , 65 , 69 , 70 , 73 – 75 , 82 ], and > 10 5 CFU/mL [ 45 ]. Three studies using BAL culture > 10 4 CFU/mL added an additional stipulation on BAL culture results: one requiring correction of microbial growth for plasma to BAL urea ratio [ 55 ], one requiring that lavage was bilateral [ 40 ], and one specifying culture took place immediately after lavage [ 60 ].…”

Section: Reference Standardmentioning

confidence: 99%

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Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

et al. 2021

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Background Ventilator-associated pneumonia (VAP) is an important diagnosis in critical care. VAP research is complicated by the lack of agreed diagnostic criteria and reference standard test criteria. Our aim was to review which reference standard tests are used to evaluate novel index tests for suspected VAP. Methods We conducted a comprehensive search using electronic databases and hand reference checks. The Cochrane Library, MEDLINE, CINHAL, EMBASE, and web of science were searched from 2008 until November 2018. All terms related to VAP diagnostics in the intensive treatment unit were used to conduct the search. We adopted a checklist from the critical appraisal skills programme checklist for diagnostic studies to assess the quality of the included studies. Results We identified 2441 records, of which 178 were selected for full-text review. Following methodological examination and quality assessment, 44 studies were included in narrative data synthesis. Thirty-two (72.7%) studies utilised a sole microbiological reference standard; the remaining 12 studies utilised a composite reference standard, nine of which included a mandatory microbiological criterion. Histopathological criteria were optional in four studies but mandatory in none. Conclusions Nearly all reference standards for VAP used in diagnostic test research required some microbiological confirmation of infection, with BAL culture being the most common reference standard used.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Reference Standardmentioning

confidence: 99%

Section: Reference Standardmentioning

confidence: 99%

Section: Reference Standardmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

et al. 2021

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Diagnostic value of pentraxin 3 in respiratory tract infections

Wu¹,

Huang²,

Tang³

et al. 2020

Medicine

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Background: Pentraxin 3 is an acute inflammatory protein of the long pentraxin subfamily. A meta-analysis was performed to assess diagnostic accuracy of pentraxin 3 for respiratory tract infections. Methods: We identify studies examining diagnostic value of pentraxin 3 for respiratory tract infections by searching Pubmed, Web of Knowledge, and Cochrane Library. The sensitivity, specificity, negative likelihood ratio (LR), positive LR, and diagnostic odds ratio were pooled. The area under the summary receiver operator characteristic (SROC) curve and Q point value (Q∗) were calculated. Results: A total of 8 studies with 961 individuals were eligible for this meta-analysis. The pooled sensitivity of pentraxin 3 in diagnosis of respiratory tract infections was 0.78, the pooled specificity was 0.73, the area under the SROC curve was 0.84, and the Q∗ was 0.77. The area under the SROC curve of serum and bronchoalveolar lavage fluid (BALF) pentraxin 3 was 0.85 and 0.89, respectively. Meta-regression analysis revealed that cutoff value was the source of heterogeneity among the included studies. The Deek funnel plot test suggested no evidence of publication bias. Subgroup analyses showed that the area under the SROC curve of pentraxin 3 in diagnosis of ventilator-associated pneumonia (VAP) was 0.89. Conclusion: Pentraxin 3 has a moderate accuracy for diagnosing respiratory tract infections and VAP. The overall diagnostic value of BALF level of pentraxin 3 is superior to its serum concentration.

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The assessment of pentraxin 3: a diagnostic and prognostic biomarker in lower respiratory tract infections in children

Madkour,

Mostafa,

El-Kady

2024

Ital J Pediatr

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Background Pentraxin 3 (PTX3) is an acute-phase reactant that is elevated in the plasma during inflammatory responses. We aimed to evaluate the utility of PTX3 as a clinical marker in children with lower respiratory tract infections (LRTIs) and the association between PTX3 and LRTIs severity. Methods We included 60 patients admitted to Fayoum University Hospital with LRTIs fulfilling the WHO criteria for diagnosing LRTIs. We collected data on peak temperature, respiratory rate, heart rate, oxygen saturation upon admission, and length of hospital stay. The complete blood count (CBC), C-reactive protein (CRP) level, and PTX3 were measured upon admission. Results PTX3 levels were significantly correlated with peak temperature, duration of hospital stay, the Pediatric Respiratory Severity Score (PRESS), total leucocytic count (TLC), CRP, and blood cultures. Conclusion PTX-3 represented the severity of the disease and predicted the prognosis. Pentraxin levels demonstrate a statistically significant sensitivity of (93.3%) and a specificity of (70%) at the cut-off value (of 8.84) with an area under the curve (90.7%) in the diagnosis of LRTIs.

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Pentraxin 3 as an early marker in diagnosis of ventilator associated pneumonia

Cited by 3 publications

References 10 publications

Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

Diagnostic value of pentraxin 3 in respiratory tract infections

The assessment of pentraxin 3: a diagnostic and prognostic biomarker in lower respiratory tract infections in children

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