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

被引：89

作者：

Su, Longxiang ^{[1
,2
,3
,4
]}

Han, Bingchao ^{[1
,2
]}

Liu, Changting ^{[4
]}

Liang, Liling ^{[2
]}

Jiang, Zhaoxu ^{[1
,2
,3
]}

Deng, Jie ^{[1
,2
]}

Yan, Peng ^{[1
]}

Jia, Yanhong ^{[2
]}

Feng, Dan ^{[5
]}

Xie, Lixin ^{[1
,2
]}

机构：

[1] Chinese Peoples Liberat Army Gen Hosp, Hainan Branch, Dept Resp Med, Sanya 572013, Hainan Province, Peoples R China

[2] Chinese Peoples Liberat Army Gen Hosp, Dept Resp Dis, Beijing 100853, Peoples R China

[3] Nankai Univ, Coll Med, Tianjin 300071, Peoples R China

[4] Chinese Peoples Liberat Army Gen Hosp, Dept Resp Dis S Bldg, Beijing 100853, Peoples R China

[5] Chinese Peoples Liberat Army Gen Hosp, Dept Med Stat, Beijing 100853, Peoples R China

来源：

BMC INFECTIOUS DISEASES | 2012年 / 12卷

关键词：

Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1); Fever; Sepsis; Bacteremia; Diagnosis; Prognosis; INFLAMMATORY RESPONSE SYNDROME; MYELOID CELLS-1; PREDICTING BACTEREMIA; BACTERIAL-INFECTION; DIAGNOSTIC-VALUE; RECEPTOR; MARKER; GUIDELINES; EPIDEMIOLOGY; DEFINITIONS;

D O I：

10.1186/1471-2334-12-157

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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 degrees 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.

引用

页数：10

共 53 条

[1] Increased plasma levels of soluble triggering receptor expressed on myeloid cells 1 and procalcitonin after cardiac surgery and cardiac arrest without infection [J].