Combination of biomarkers for the discrimination between bacterial and viral lower respiratory tract infections
Publication year
2012Source
Journal of Infection, 65, 6, (2012), pp. 490-5ISSN
Publication type
Article / Letter to editor

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Organization
Intensive Care
Internal Medicine
Journal title
Journal of Infection
Volume
vol. 65
Issue
iss. 6
Page start
p. 490
Page end
p. 5
Subject
IGMD 7: Iron metabolism N4i 1: Pathogenesis and modulation of inflammation; N4i 1: Pathogenesis and modulation of inflammation NCMLS 1: Infection and autoimmunity; N4i 2: Invasive mycoses and compromised host; N4i 2: Invasive mycoses and compromised hostAbstract
OBJECTIVES: To investigate whether additional determinations of plasma lipopolysaccharide binding protein (LBP), procalcitonin (PCT), interleukin-6 (IL-6), IL-18, or soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) to C-reactive protein (CRP) improve the discrimination between bacterial and viral lower respiratory tract infections (LRTI). METHODS: Out of 342 patients visiting the emergency department because of a suspected infection and >/=2 clinical signs of sepsis, 56 patients with proven bacterial (n = 39) or viral (n = 17) LRTI were included. The area under the ROC curves (AUC) of the five possible combinations of CRP with one other biomarker were compared with the AUC of CRP alone. Next, the same analysis was performed in the group of patients with a CRP concentration with <95% specificity for bacterial LRTI. RESULTS: While CRP, PCT, IL-6, sTREM-1, and LBP concentrations were significantly different between patients with bacterial or viral LRTI, the AUC of CRP (0.82, 95%CI 0.70-0.93) did not increase after combination analyses. After exclusion of patients with a CRP >150 mg/l, biomarker panel analyses did not improve diagnostic accuracy of CRP either. CONCLUSIONS: Combining CRP with LBP, PCT, IL-6, IL-18, or sTREM-1 does not improve differentiation between patients with a bacterial or viral LRTI compared with CRP alone.
This item appears in the following Collection(s)
- Academic publications [202802]
- Faculty of Medical Sciences [80020]
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