New Biomarkers to Diagnose Ventilator Associated Pneumonia: Pentraxin 3 and Surfactant Protein D

作者：Tekerek Nazan Ulgen^*; Akyildiz Basak Nur; Ercal Baris Derya; Muhtaroglu Sabahattin

来源：Indian Journal of Pediatrics, 2018, 85(6): 426-432.

DOI：10.1007/s12098-018-2607-2

• Surfactant protein D
• Pentraxin 3
• Ventilator associated pneumonia

Objective To detect the most effective biomarker to confirm ventilator associated pneumonia (VAP).
Methods Fifty patients with VAP suspicious diagnosis and 30 healthy patients were recruited. Suspicion of VAP was established if patients met the modified CPIS score >= 6 points. The confirmation of VAP was defined by the quantitative culture of nonbronchoscopic bronchoalveolar lavage (BAL) >10(5) CFU/ml of pathogenic microorganism. Serum samples for determination of C-reactive protein (CRP), procalcitonin (PCT), pentraxin 3 (PTX3), surfactant protein D (SPD) were collected on suspected VAP.
Results Twenty seven of 50 patients were accepted as confirmed VAP group whose nonbronchoscopic BAL cultures were positive and rest of them were accepted as unconfirmed VAP group. PTX3, PCT and SPD levels were significantly higher in confirmed VAP group, (P = 0.021, P = 0.007, P< 0.001 respectively). There were no significant differences in CRP levels between the two groups (P= 0.062). The most sensitive marker for diagnosing VAP was SPD (P< 0.001). Receiver operating characteristic (ROC) curve for modified clinical pulmonary infection score (CPIS) to confirm VAP was evaluated (AUC 0.741 +/- 0.07, P< 0.001) and the optimal cutoff value was >7 with a sensitivity of 51.85% and a specificity of 91.3%. SPD levels were significantly higher in Acinetobacter baumannii and Pseudomonas aeruginosa infected patients than culture negative patients (P < 0.001).
Conclusions The index findings suggest that serum SPD is the most sensitive biomarker in diagnosis of VAP and it can be used as an early and organism specific marker for Acindobacter baumannii and Pseudomonas aeruginosa.

• 出版日期2018-6