sTREM-1 is a potential useful biomarker for exclusion of ongoing infection in patients with secondary peritonitis

Determann, Rogier M.; Till, J. W. Olivier van; Ruler, Oddeke van; Veen, Suzanne Q. van; Schultz, Marcus J.; Boermeester, Marja A.

doi:10.1016/j.cyto.2008.12.006

Cited by 25 publications

(15 citation statements)

References 24 publications

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“…sTREM-1 is a soluble form of TREM-1 that may be released into body fluids upon the up-regulated expression of TREM-1 [7]. An increasing number of studies indicate that there are increased levels of sTREM-1 in body fluid samples for the following diseases and conditions: sepsis, pneumonia, pleural effusion, septic arthritis, meningitis, peritonitis and uterine cavity infection [8-14]. This suggests that sTREM-1 may be a valuable diagnostic indicator for making distinctions between infectious and non-infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of urine sTREM-1 for sepsis and relevant acute kidney injuries: a prospective study

Feng

Zhang

et al. 2011

Crit Care

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IntroductionWe explored the diagnostic value of a urine soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for early sepsis identification, severity and prognosis assessment, and for secondary acute kidney injury (AKI). We compared this with white blood cell (WBC) counts, serum C-reactive protein (CRP), serum procalcitonin (PCT), urine output, creatinine clearance (CCr), serum creatinine (SCr), and blood urea nitrogen (BUN).MethodsWe enrolled 104 subjects admitted to the ICU: 16 cases with systemic inflammatory response syndrome (SIRS); 35 with sepsis and 53 with severe sepsis. Results for urine sTREM-1, WBC, serum CRP and serum PCT were recorded on days 1, 3, 5, 7, 10, and 14. For 17 sepsis cases diagnosed with secondary AKI, comparisons between their urine sTREM-1, urine output, CCr, SCr and BUN at diagnosis and 48 h before diagnosis were made.ResultsOn the day of admission to the ICU, and compared with the SIRS group, the sepsis group exhibited higher levels of urine sTREM-1 and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) scores (P < 0.05). Areas under the curve (AUC) shaped by the scores were 0.797 (95% CI 0.711 to 0.884) and 0.722 (95% CI 0.586 to 0.858), respectively. On days 1, 3, 5, 7, 10, and 14, urine sTREM-1, serum PCT and WBC levels registered higher in the severe sepsis group in contrast to the sepsis group (P < 0.05). Urine sTREM-1 and serum PCT levels continuously increased among non-survivors, while WBC and serum CRP levels in both groups declined. For 17 patients with AKI, urine sTREM-1, SCr and BUN levels at 48 h before AKI diagnosis were higher, and CCr level was lower than those for non-AKI subjects (P < 0.05). AUC for urine sTREM-1 was 0.922 (95% CI 0.850 to 0.995), the sensitivity was 0.941, and the specificity was 0.76 (based on a cut-off point of 69.04 pg/ml). Logistic regression analysis showed that urine sTREM-1 and severity were risk factors related to AKI occurrence.ConclusionsBesides being non-invasive, urine sTREM-1 testing is more sensitive than testing WBC, serum CRP, and serum PCT for the early diagnosis of sepsis, as well as for dynamic assessments of severity and prognosis. It can also provide an early warning of possible secondary AKI in sepsis patients.Trial RegistrationClinicalTrial.gov identifier NCT01333657

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Section: Introductionmentioning

confidence: 99%

Diagnostic value of urine sTREM-1 for sepsis and relevant acute kidney injuries: a prospective study

Feng

Zhang

et al. 2011

Crit Care

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“…sTREM-1 is better than PCT in the prediction of infection at the onset of neutropenic fever [18]. Determann's study [19] showed that abdominal fluid sTREM-1 levels may be useful for exclusion but not detection of ongoing abdominal infection after surgery for secondary peritonitis. Recent studies show that serum sTREM-1 level is significantly increased and correlates with disease severity and early organ dysfunction in patients with AP.…”

Section: Discussionmentioning

confidence: 99%

Soluble triggering receptor expressed on myeloid cells in severe acute pancreatitis: a biological marker of infected necrosis

et al. 2011

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“…The ideal marker should be present early in the course of the disease, be measurable rapidly and easily, of prognostic significance, sensitive enough to detect infection in patients with minimal host response, and specific enough to discriminate infection from other causes of SIRS [14]. A significant amount of evidence has accumulated regarding the clinical potential of TREM-1 as a marker [11,12,[15][16][17][18][19][20][21][22]. The protein is upregulated and expressed in response to binding of bacterial agonists by neutrophils and monocytes.…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, with upregulation of membrane-bound TREM-1, sTREM-1 is released, and its concentration can be measured in biological fluids [10]. Thus, sTREM-1 may act as a marker of bacterial infection and was a promising diagnostic tool in previous studies performed in medical ICUs [11][12]. However, this marker has not been evaluated in a surgical ICU.…”

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confidence: 99%

Soluble Triggering Receptor Expressed on Myeloid Cells-1 Is an Early Marker of Infection in the Surgical Intensive Care Unit

Rivera-Chavez

Minei

2009

Surgical Infections

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Background: To determine the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in early differentiation of systemic inflammatory response syndrome (SIRS) from infection in patients in a surgical intensive care unit (ICU). Methods: Patients were enrolled if there was clinical suspicion of infection and they fulfilled at least two criteria of SIRS at the time of admission to the ICU. The patients were classified as having SIRS (no infection; n ¼ 37) or infection (n ¼ 56) on the basis of the decision of the treating physician and bacteriological evidence of infection. The plasma concentrations of sTREM-1 in the two groups were compared. Results: Patients with infection had significantly higher sTREM-1 concentrations than patients with SIRS: Median 398 pg=mL (interquartile range [IQR] 302, 552) vs. 78 pg=mL (IQR 28, 150), respectively (p < 0.0001). At a cut-off of 230 pg=mL, sTREM-1 correctly identified patients suffering from infection with 96% sensitivity and 91% specificity. Conclusions: In the present study, sTREM-1 was an accurate tool for differentiating SIRS from infection in patients in the surgical ICU.

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sTREM-1 is a potential useful biomarker for exclusion of ongoing infection in patients with secondary peritonitis

Cited by 25 publications

References 24 publications

Diagnostic value of urine sTREM-1 for sepsis and relevant acute kidney injuries: a prospective study

Diagnostic value of urine sTREM-1 for sepsis and relevant acute kidney injuries: a prospective study

Soluble triggering receptor expressed on myeloid cells in severe acute pancreatitis: a biological marker of infected necrosis

Soluble Triggering Receptor Expressed on Myeloid Cells-1 Is an Early Marker of Infection in the Surgical Intensive Care Unit

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