Triggering receptor (TREM‐1) expressed on myeloid cells predicts bacteremia better than clinical variables in community‐acquired pneumonia

Ruiz-González, Agustı́n; Esquerda, Aureli; Falguera, Miquel; Abdulghani, Nadia; Cabezas, Pamela; Bielsa, Silvia; Porcel, José M.

doi:10.1111/j.1440-1843.2010.01905.x

Cited by 17 publications

(22 citation statements)

References 19 publications

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“…The authors concluded that plasma sTREM-1 had moderate diagnostic performance in differentiating sepsis from SIRS. Moreover, some researchers have suggested that PCT and CRP are more sensitive biomarkers than sTREM-1 for diagnosis of bacterial infection [32, 33]. In the present study, we found that plasma sTREM-1 and PCT values, as well as APACHE II score, were significantly higher in patients with sepsis than in patients with SIRS.…”

Section: Discussionsupporting

confidence: 60%

Diagnostic value of sTREM-1 and procalcitonin levels in the early diagnosis of sepsis

Aksaray

Alagoz

İnan

et al. 2016

North Clin Istanbul

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OBJECTIVE:Sepsis is still major cause of morbidity and mortality, despite improvements in diagnosis and treatment in modern medicine. Therefore, laboratory examinations that provide correct and rapid results are needed to support the diagnosis. This study was conducted to investigate value of immunological indicators procalcitonin (PCT) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in differential diagnosis of patients with sepsis and systemic inflammatory response syndrome (SIRS), as well as to assess their importance in determining prognosis of patients with sepsis.METHODS:Total of 90 patients, 38 with SIRS and 52 with sepsis, who were between the ages 20 to 92, were included in this prospectively planned study. Blood sample was collected from the patients during hospitalization and again in follow-up visit. Enzyme-linked immunosorbent assay (MyBioSource, Inc., San Diego, CA, USA) was used to measure sTREM-1, and PCT was measured using mini VIDAS B.R.A.H.M.S PCT assay (Biomerieux, S.A., Marcy-l’Étoile, France). In addition, patients were clinically assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system.RESULTS:On day of intensive care unit admission, sTREM-1 and PCT levels, as well as APACHE II score were significantly higher in sepsis group than SIRS group (p=0.001, p=0.01, p=0.001, respectively). Values of sTREM-1 and APACHE II score were higher in the patients with positive blood cultures than those with negative culture results (p=0.002, p=0.006, respectively). PCT, C-reactive protein, and sTREM-1 levels were significantly higher in nonsurviving group. In differentiation of SIRS from sepsis, sTREM-1 cut-off value ≥133 pg/mL and PCT cut-off value of 1.57 ng/mL yielded sensitivity of 71.1% and 67.33%, and specificity of 73.3% and 65.79%, respectively.CONCLUSION:In patients with suspected sepsis, sTREM-1 and PCT can be used as indicators, in addition to scoring systems such as APACHE II and Sepsis-related Organ Failure Assessment score. However, it would be appropriate to support present findings with studies of larger series.

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Section: Discussionsupporting

confidence: 60%

Diagnostic value of sTREM-1 and procalcitonin levels in the early diagnosis of sepsis

Aksaray

Alagoz

İnan

et al. 2016

North Clin Istanbul

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“…However, Blijlevens et al [50] questioned the value of PCT levels in sepsis diagnosis. Ruiz-Gonzalez et al [51] recently suggested that sTREM-1 levels are valuable for diagnosing bacteremia with community-acquired pneumonia. Because fewer studies have shown the value of sTREM-1 in the diagnosis of bacteremia, we divided ICU patients with fever into blood culture-positive bacteremia and blood culture-negative groups based on their blood culture results.…”

Section: Discussionmentioning

confidence: 99%

Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: a prospective cohort study

et al. 2012

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Background The purpose of this study was to explore the diagnostic value of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), procalcitonin (PCT), and C-reactive protein (CRP) serum levels for differentiating sepsis from SIRS, identifying new fever caused by bacteremia, and assessing prognosis when new fever occurred. Methods We enrolled 144 intensive care unit (ICU) patients: 60 with systemic inflammatory response syndrome (SIRS) and 84 with sepsis complicated by new fever at more than 48 h after ICU admission. Serum sTREM-1, PCT, and CRP levels were measured on the day of admission and at the occurrence of new fever (>38.3°C) during hospitalization. Based on the blood culture results, the patients were divided into a blood culture-positive bacteremia group (33 patients) and blood culture-negative group (51 patients). Based on 28-day survival, all patients, both blood culture-positive and -negative, were further divided into survivor and nonsurvivor groups. Results On ICU day 1, the sepsis group had higher serum sTREM-1, PCT, and CRP levels compared with the SIRS group ( P <0.05). The areas under the curve (AUC) for these indicators were 0.868 (95% CI, 0.798–0.938), 0.729 (95% CI, 0.637–0.821), and 0.679 (95% CI, 0.578–0.771), respectively. With 108.9 pg/ml as the cut-off point for serum sTREM-1, sensitivity was 0.83 and specificity was 0.81. There was no statistically significant difference in serum sTREM-1 or PCT levels between the blood culture-positive and -negative bacteremia groups with ICU-acquired new fever. However, the nonsurvivors in the blood culture-positive bacteremia group had higher levels of serum sTREM-1 and PCT ( P <0.05), with a prognostic AUC for serum sTREM-1 of 0.868 (95% CI, 0.740–0.997). Conclusions Serum sTREM-1, PCT, and CRP levels each have a role in the early diagnosis of sepsis. Serum sTREM-1, with the highest sensitivity and specificity of all indicators studied, is especially notable. sTREM-1, PCT, and CRP levels are of no use in determining new fever caused by bacteremia in ICU patients, but sTREM-1 levels reflect the prognosis of bacteremia. Trial registration ClinicalTrial.gov identifier NCT01410578

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“…Such biomarkers include CRP, procalcitonin and triggering receptor expressed on myeloid cells (TREM-1). TREM-1 is a member of the immunoglobulin superfamily, is up-regulated by microbial products [124] and may stimulate secretion of several cytokines and chemokines [125]. The serum soluble TREM-1 was associated with bacteremic CAP [125] while soluble TREM-1 in bronchoalveolar lavage fluid was associated with bacterial pneumonia [124].…”

Section: Current Methods Of Diagnosing Pneumococcal Pneumoniamentioning

confidence: 99%

Diagnosis of Pneumococcal Pneumonia: Current Pitfalls and the Way Forward

2013

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Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. However, it can also asymptomatically colonize the upper respiratory tract. Because of the need to distinguish between S. pneumoniae that is simply colonizing the upper respiratory tract and S. pneumoniae that is causing pneumonia, accurate diagnosis of pneumococcal pneumonia is a challenging issue that still needs to be solved. Sputum Gram stains and culture are the first diagnostic step for identifying pneumococcal pneumonia and provide information on antibiotic susceptibility. However, these conventional methods are relatively slow and insensitive and show limited specificity. In the past decade, new diagnostic tools have been developed, particularly antigen (teichoic acid and capsular polysaccharides) and nucleic acid (ply, lytA, and Spn9802) detection assays. Use of the pneumococcal antigen detection methods along with biomarkers (C-reactive protein and procalcitonin) may enhance the specificity of diagnosis for pneumococcal pneumonia. This article provides an overview of current methods of diagnosing pneumococcal pneumonia and discusses new and future test methods that may provide the way forward for improving its diagnosis.

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Triggering receptor (TREM‐1) expressed on myeloid cells predicts bacteremia better than clinical variables in community‐acquired pneumonia

Abstract: This preliminary study suggests that the determination of sTREM-1 serum levels on admission may be more accurate than clinical variables for identifying bacteremic patients.

Cited by 17 publications

References 19 publications

Diagnostic value of sTREM-1 and procalcitonin levels in the early diagnosis of sepsis

Diagnostic value of sTREM-1 and procalcitonin levels in the early diagnosis of sepsis

Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: a prospective cohort study

Diagnosis of Pneumococcal Pneumonia: Current Pitfalls and the Way Forward

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