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

2020 ◽  
Author(s):  
Jian Zhou ◽  
Jingqian Zhou ◽  
Yan Hong ◽  
Youcheng Wang ◽  
Hailong Lin ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Roc Analysis ◽  
Myeloid Cells ◽  
Diagnostic Value ◽  
Full Term ◽  
Controlled Clinical Trial ◽  
Ventilator Associated Pneumonia ◽  
C Reactive Protein ◽  
Term Neonates ◽  
Reactive Protein

Abstract 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

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

2020 ◽  
Author(s):  
Jian Zhou ◽  
Jingqian Zhou ◽  
Yan Hong ◽  
Youcheng Wang ◽  
Hailong Lin ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Roc Analysis ◽  
Myeloid Cells ◽  
Diagnostic Value ◽  
Full Term ◽  
Controlled Clinical Trial ◽  
Ventilator Associated Pneumonia ◽  
C Reactive Protein ◽  
Term Neonates ◽  
Reactive Protein

Abstract 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. Conclusion: BAL-fluid sTREM-1 and serum C-reactive protein concentrations may be useful for the diagnosis of NVAP.

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

2021 ◽  
Vol 9 ◽  
Author(s):  
Jian Zhou ◽  
Jingqian Zhou ◽  
Yan Hong ◽  
Youcheng Wang ◽  
Hailong Lin ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Roc Analysis ◽  
Myeloid Cells ◽  
Diagnostic Value ◽  
Full Term ◽  
Controlled Clinical Trial ◽  
Ventilator Associated Pneumonia ◽  
C Reactive Protein ◽  
Term Neonates ◽  
Reactive Protein

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.

scholarly journals Salivary Interleukin-6 and C-Reactive Protein/Mean Platelet Volume Ratio in the Diagnosis of Late-Onset Neonatal Pneumonia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ahmed Omran ◽  
Yasmin Ali ◽  
Mohamed Osama Abdalla ◽  
Sonya El-Sharkawy ◽  
Ahmed R. Rezk ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Predictive Value ◽  
Mean Platelet Volume ◽  
Late Onset ◽  
Case Fatality ◽  
Full Term ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Term Neonates ◽  
Reactive Protein

Neonatal pneumonia is a serious respiratory infectious disease with a high rate of case fatality in developing countries. Salivary cytokines could serve as interesting noninvasive markers in the diagnosis of neonatal pneumonia. The aim was to assess the diagnostic role of salivary and serum interleukin-6 (IL-6), C-reactive protein/mean platelet volume (CRP/MPV) ratio, and the combination of these markers in the diagnosis of late-onset neonatal pneumonia in full-term neonates. Seventy full-term neonates, 35 with late-onset neonatal pneumonia and 35 controls, were enrolled in this prospective case-control study. Complete blood count (CBC), salivary and serum IL-6, and CRP concentrations were measured for all the study subjects. The sensitivity, specificity, positive predictive value, and negative predictive value of salivary IL-6, serum IL-6, and CRP/MPV ratio for the diagnosis of late-onset neonatal pneumonia were determined. At the cutoff point of >34 pg/ml, salivary IL-6 showed 82.86% sensitivity and 91.43% specificity. CRP/MPV ratio showed a sensitivity of 97.14% and specificity of 85.71% at a cutoff   value > 0.88 . The combination of salivary IL-6 and CRP/MPV ratio improved the sensitivity and specificity to 100%. The current study shows for the first time that both salivary IL-6 and CRP/MPV ratio are suitable markers for the diagnosis of late-onset neonatal pneumonia in full-term neonates.

scholarly journals Diagnostic value of triggering receptor expressed on myeloid cells-1 and C-reactive protein for patients with lung infiltrates: an observational study

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Ilias Porfyridis ◽  
Diamantis Plachouras ◽  
Vasiliki Karagianni ◽  
Anastasia Kotanidou ◽  
Spyridon A Papiris ◽  
...  
Keyword(s):  
Observational Study ◽  
Myeloid Cells ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lung Infiltrates

scholarly journals Salivary and Serum Interleukin-10, C-Reactive Protein, Mean Platelet Volume, and CRP/MPV Ratio in the Diagnosis of Late-Onset Neonatal Sepsis in Full-Term Neonates

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ahmed Omran ◽  
Hazem Sobh ◽  
Mohamed Osama Abdalla ◽  
Sonya El-Sharkawy ◽  
Ahmed R. Rezk ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Mean Platelet Volume ◽  
Late Onset ◽  
Interleukin 10 ◽  
Full Term ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Term Neonates ◽  
Reactive Protein ◽  
Late Onset Sepsis

Salivary markers could serve as potential noninvasive markers in the diagnosis of neonatal infections. We aimed to investigate the diagnostic role of salivary and serum interleukin 10 (IL-10), C-reactive protein (CRP), mean platelet volume (MPV), and CRP/MPV ratio in the diagnosis of late-onset neonatal sepsis in full-term neonates. Seventy full-term neonates were enrolled in this prospective case-control study, 35 with late-onset neonatal sepsis, and 35 controls. Salivary IL-10, serum IL-10, and CRP concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Complete blood (CBC) count was measured by an automated blood cell counter. The salivary IL-10, serum IL-10, CRP, MPV, and CRP/MPV ratio levels were much higher in neonates with late-onset sepsis than in control ( 220 ± 150 vs. 18 ± 9   pg / ml , P < 0.001 ), ( 316 ± 198 vs. 23.7 ± 14   pg / ml , P < 0.001 ), ( 78.2 ± 34 vs. 3.3 ± 1.7   mg / L , P < 0.001 ), ( 11.2 ± 0.9 vs. 8.6 ± 0.4   fL ), and ( 7.08 ± 3.3 vs. 0.4 ± 0.2 , P < 0.001 ), respectively. At the cutoff point of >31 pg/ml, salivary IL-10 showed 97.1% sensitivity and 94.3% specificity. Serum IL-10 at a cutoff value of ≥33.6 pg/ml had a sensitivity of 97.1% and specificity of 80%. MPV showed a sensitivity of 100% and specificity of 94.4% at a cutoff   value ≥ 9.2   fL . CRP/MPV ratio showed a sensitivity of 100% and specificity of 97.1% at a cutoff   value > 0.9 . Salivary and serum IL-10 showed a positive correlation with CRP and CRP/MPV ratio in septic neonates. The current study shows for the first time that both salivary IL-10 and CRP/MPV showed statistically significant differences between neonates with late-onset sepsis and controls. Accordingly, salivary IL-10 could serve as a potential noninvasive biomarker for the diagnosis of late-onset sepsis in full-term neonates.

scholarly journals Severe extensive community acquired aspergillus infection in a full‐term infant accompanied with increases in white blood cell counts and C-reactive protein: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanli Wang ◽  
Wenjing Chen ◽  
Wenshen Wu ◽  
Dongling Yu ◽  
Huiheng Yan ◽  
...  
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Fungal Infections ◽  
Full Term ◽  
Pathological Examination ◽  
C Reactive Protein ◽  
Term Neonates ◽  
Aspergillus Infection ◽  
Reactive Protein ◽  
Wbc Count

Abstract Background Aspergillus infection is more common among premature infants in neonatal intensive care units, who have decreased qualitative immune defenses and need various invasive treatment procedures. It is rare in normal full-term neonates, especially in newborn babies from the community. Moreover, the white blood cell (WBC) count and C-reactive protein (CRP) level may be normal or slightly changed in fungal infections, but the neonate reported in this study had significant increases in WBC and CRP. To the best of our knowledge, this is the first report on a full-term neonate from the community with aspergillus infection accompanied by significant increases in WBC and CRP levels. Case presentation A 28-day-old infant, who received empirical antibiotic treatment for 10 days because of neonatal pneumonia, was referred to our neonatal department from the local hospital. The infant had persistent infection and multiple organ failure syndromes. Bronchoscopy and deep sputum smear were performed to identify the pathogen, which confirmed aspergillus infection in the sputum. Fluconazole was immediately administered, but the baby died after three days. Thereafter, an autopsy was performed with parental consent. There were multiple necrotic areas in the lungs and liver, and pathological examination revealed aspergillus. Conclusions The present case emphasized that community-sourced aspergillus infection can exist in full-term neonates, with significantly increased WBC count and CRP level. Advanced antibiotics were not effective in this case, and fungal infections should have been considered earlier.

Diagnostic value of procalcitonin, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP) and clinical findings associated with osteomyelitis in patients with diabetic foot

2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Roc Curve ◽  
Diabetic Foot ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

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