Soluble Triggering Receptor Expressed on Myeloid Cells 1 and the Diagnosis of Ventilator-Associated Pneumonia: Response

Kollef, Marin H.; Anand, Nitin; Zuick, Scott; Klesney-Tait, Julia

doi:10.1378/chest.09-0755

Cited by 3 publications

(4 citation statements)

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“…Nevertheless, the ability of sTREM-1 to diagnose infectious diseases remains controversial. As reported by Kollef et al, plasma sTREM-1 may be involved in lymphocytic regulation and differentiation during fungal infections [ 13 ]. According to recent studies, sTREM1 is elevated in plasma and bronchoalveolar lavage fluid from infected patients with bacterial or fungal pneumonia [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 95%

Role of biomarkers in the diagnosis of invasive aspergillosis in immunocompromised patients

Badiee

Ghasemi

Jafarian

2022

Ann Clin Microbiol Antimicrob

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Background Invasive aspergillosis is one of the important causes of infection in immunocompromised patients. This study aimed to evaluate the roles of biomarkers in the diagnosis of invasive aspergillosis and their relationship with antifungal stewardship programs. Methods 190 sera from 52 immunocompromised patients and volunteer individuals were included in this study. 18 immunocompromised volunteers without IA and 34 patients with probable and proven aspergillosis according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group consensus definitions were entered in this study. The respective sera were evaluated for procalcitonin, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels; white blood cells count (WBC) count, C reactive protein (CRP), lactate dehydrogenase (LDH), and erythrocyte sedimentation rate (ESR) values. Demographic data and clinical characteristics of patients were extracted from their files. Results The male-to-female ratio and mean age of patients were 22/12 and 38.9 years, respectively. The hematologic disorder was the most predisposing factor (29/34, 85.3%). Sensitivity of biomarkers for diagnosis of invasive aspergillosis was 70.6% (cut off value > 190 pg/mL for sTREM-1, 71% (cut off value > 260 pg/mL) for PCT, 85.3% (cut off value > 193 U/L) for LDH, 94.1% (cut off value > 8 mg/l) for CRP, 64.7% (cut off value < 5200 cells/ml) for WBC, and 85.3% (cut off value > 23 mm/h) for ESR. Twelve patients died, with significantly increased sTREM-1 levels and decreased WBC count in them. Conclusion According to our data, evaluation of the biomarkers can help in the diagnosis, management, and prediction of the severity of Aspergillus infection, and the rational use of antifungal agents in immunocompromised patients.

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Section: Introductionmentioning

confidence: 95%

Role of biomarkers in the diagnosis of invasive aspergillosis in immunocompromised patients

Badiee

Ghasemi

Jafarian

2022

Ann Clin Microbiol Antimicrob

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“…sTREM-1 can be measured directly in human body uids, including serum, pleural effusion, sputum, and urine, during infections [14,17]. The concentration of sTREM-1 has been demonstrated to rise in the BAL uid of VAP patients [6,[18][19][20], including a pediatric research of VAP patients after cardiac surgery, but none about neonatal VAP [21].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of bronchoalveolar lavage-fluid soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) concentration for neonatal ventilator-associated pneumonia

Zhou¹,

Zhou²,

Hong

et al. 2020

Preprint

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Background: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has regarded as a biological marker of infection.We aimed to evaluate the diagnostic value of bronchoalveolar lavage (BAL)-sTREM-1 concentration in neonatal ventilator-associated pneumonia (NVAP).Methods: In this multicenter, controlled clinical trial of 60 preterm and 33 full-term neonates on mechanical ventilators, we measured concentrations of BAL-fluid and serum sTREM-1, serum C-reactive protein, and serum procalcitonin, as well as white blood cell count. We initially divided cases into eight groups, based on three categories: preterm of full-term; NVAP or non-NVAP; and extrapulmonary infection present or absent. Groups were compared, and logistic regression analysis and receiver operating characteristic (ROC) analysis was performed to determine diagnostic value.Results: The mean gestational age (± standard deviation) of preterm and full-term neonates was 28.9±2.2 weeks and 39.5±1.7 weeks, respectively, and 32/60 were male. The BAL-fluid sTREM-1 concentration was higher in NVAP cases than in non-NVAP cases, irrespective of extrapulmonary infection. ROC analysis revealed that BAL-fluid sTREM-1 concentration had an area under the curve (AUC) of 0.986 and a cutoff value of 228.0 pg/ml (sensitivity, 94.3%; specificity, 96%) in preterm neonates; the same values in full-term neonates were 0.938 and 245.5 pg/ml (sensitivity, 100%; specificity, 93.7%), respectively. The optimal combination of indicators was BAL-fluid sTREM-1 and serum C-reactive protein concentration. All indicators were present at lower levels on days 8 and 10 of ventilation in neonates who ultimately recovered than in those who did not. Conclusions: BAL-fluid sTREM-1 and serum C-reactive protein concentrations may be useful for the diagnosis of NVAP.Blinded manuscript textThe RCT was approved by the Ethics Review Committee ofThe First People's Hospital of Yongkang (number: ykyy201803). Furthermore, the study was registered in and approved by the Registration Centre of Clinical Trials in China (approval number: ChiCTR1900020564). URL of trial registry record:http://www.chictr.org.cn/showproj.aspx?proj=22336 Date of registration:2017-10-19

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“…(1) temperature >38 • C or <36 • C; (2) white blood cell count >12,000/mm 3 or <4,000/mm 3 ; (3) purulent/increased/change in character of respiratory secretions; (4) positive tracheal/endotracheal tube cultures; (5) signs of respiratory distress, such as shortness of breath, rapid breathing, or abnormal breathing sounds upon auscultation; (6) increased oxygen requirement/ventilator demand; (7) at least two serial chest X-rays revealing sustained/worsening shadowing (infiltrates/consolidations); and (8) positive cultures obtained directly from lung tracheal aspirates. In this study, we diagnosed a patient with NVAP based on criterion (7) and at least three of criteria ( 1)-( 6); we also diagnosed a patient with NVAP based on criterion (8).…”

Section: Participantsmentioning

confidence: 99%

“…It is up-regulated in effector cells infected by bacteria and fungi. In critically ill adults with VAP, the elevated levels of sTREM-1 were found in endotracheal tube-aspirate (ETT-aspirate) and exhaled ventilator condensate (EVC) (6)(7)(8)(9). Biological markers of infection, such as soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), may improve the accuracy of the diagnosis of VAP (6,10).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Endotracheal Tube-Aspirate Soluble Triggering Receptor Expressed on Myeloid Cells-1 Concentration for Neonatal Ventilator-Associated Pneumonia

Zhou

Yan

et al. 2021

Front. Pediatr.

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Background: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is regarded as a biological marker of infection. We aimed to evaluate the diagnostic value of endotracheal tube (ETT)-sTREM-1 concentration in neonatal ventilator-associated pneumonia (NVAP), to explore the difference of (ETT)-sTREM-1 between preterm and full-term, and to investigate the influence of extrapulmonary infection on (ETT)-sTREM-1 concentration.Methods: In this multicenter, controlled clinical trial of 60 preterm and 33 full-term neonates on mechanical ventilators, we measured concentrations of ETT-aspirate and serum sTREM-1, serum C-reactive protein, and serum procalcitonin, as well as white blood cell count. We initially divided cases into eight groups, based on three categories: preterm of full-term; NVAP or non-NVAP; and extrapulmonary infection present or absent. Groups were compared, and logistic regression analysis and receiver operating characteristic (ROC) analysis was performed to determine diagnostic value.Results: The mean gestational age (± standard deviation) of preterm and full-term neonates was 28.9 ± 2.2 weeks and 39.5 ± 1.7 weeks, respectively, and 32/60 were male. The ETT-aspirate sTREM-1 concentration was higher in NVAP cases than in non-NVAP cases, irrespective of extrapulmonary infection. ROC analysis revealed that ETT-aspirate sTREM-1 concentration had an area under the curve (AUC) of 0.986 and a cutoff value of 228.0 pg/ml (sensitivity, 94.3%; specificity, 96%) in preterm neonates; the same values in full-term neonates were 0.938 and 245.5 pg/ml (sensitivity, 100%; specificity, 93.7%), respectively. The optimal combination of indicators was ETT-aspirate sTREM-1 and serum C-reactive protein concentration. All indicators were present at lower levels on days 8 and 10 of ventilation in neonates who ultimately recovered than in those who did not.Conclusions: ETT-aspirate sTREM-1 and serum C-reactive protein concentrations may be useful for the diagnosis of NVAP.

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Soluble Triggering Receptor Expressed on Myeloid Cells 1 and the Diagnosis of Ventilator-Associated Pneumonia: Response

Cited by 3 publications

References 1 publication

Role of biomarkers in the diagnosis of invasive aspergillosis in immunocompromised patients

Role of biomarkers in the diagnosis of invasive aspergillosis in immunocompromised patients

Diagnostic value of bronchoalveolar lavage-fluid soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) concentration for neonatal ventilator-associated pneumonia

Diagnostic Value of Endotracheal Tube-Aspirate Soluble Triggering Receptor Expressed on Myeloid Cells-1 Concentration for Neonatal Ventilator-Associated Pneumonia

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