Startseite Diagnostic values of CD64, C-reactive protein and procalcitonin in ventilator-associated pneumonia in adult trauma patients: a pilot study
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Diagnostic values of CD64, C-reactive protein and procalcitonin in ventilator-associated pneumonia in adult trauma patients: a pilot study

  • Sara F. Habib , Ahmed M. Mukhtar , Hossam M. Abdelreheem , Mervat M. Khorshied , Riham El sayed , Mohamed H. Hafez , Heba M. Gouda , Doaa M. Ghaith , Ahmed Mohamed Hasanin EMAIL logo , Akram S. Eladawy , Mai A. Ali und Ahmed Z. Fouad
Veröffentlicht/Copyright: 24. Oktober 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 54 Heft 5

Abstract

Background:

Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections; however, its diagnosis remains difficult to establish in the critical care setting. We investigated the potential role of neutrophil CD64 (nCD64) expression as an early marker for the diagnosis of VAP.

Methods:

Forty-nine consecutive patients with clinically suspected VAP were prospectively included in a single-center study. The levels of nCD64, C-reactive protein (CRP), and serum procalcitonin (PCT) were analyzed for diagnostic evaluation at the time of intubation (baseline), at day 0 (time of diagnosis), and at day 3. The receiver operating characteristic curves were analyzed to identify the ideal cutoff values.

Results:

VAP was confirmed in 36 of 49 cases. In patients with and without VAP, the median levels (interquartile range, IQR) of nCD64 did not differ either at baseline [2.4 (IQR, 1.8–3.1) and 2.6 (IQR, 2.3–3.2), respectively; p=0.3] or at day 0 [2 (IQR, 2.5–3.0) and 2.6 (IQR, 2.4–2.9), respectively; p=0.8]. CRP showed the largest area under the curve (AUC) at day 3. The optimum cutoff value for CRP according to the maximum Youden index was 133 mg/dL. This cutoff value had 69% sensitivity and 76% specificity for predicting VAP; the AUC was 0.73 (95% CI, 0.59–0.85). The nCD64 and PCT values could not discriminate between the VAP and non-VAP groups either at day 0 or day 3.

Conclusions:

The results of this pilot study suggest that neutrophil CD64 measurement has a poor role in facilitating the diagnosis of VAP and thus may not be practically recommended to guide the administration of antibiotics when VAP is suspected.

Keywords: biomarkers; CD64; CRP; procalcitonin; ventilator-associated pneumonia
Corresponding author: Ahmed Mohamed Hasanin, MD, Faculty of Medicine, Department of Anesthesia and Critical Care, Cairo University, 1 Al-Saray Street, Al-Manial, Cairo 11559, Egypt, Phone: +201112737771, Fax: +20223641687, E-mail:

Acknowledgments

We thank the residents, nursing staff, and data collection personnel of our unit for drafting this work.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. This work was carried out at Cairo University Hospital.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-7-10
Accepted: 2015-9-25
Published Online: 2015-10-24
Published in Print: 2016-5-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2015-0656
Schlagwörter für diesen Artikel
biomarkers; CD64; CRP; procalcitonin; ventilator-associated pneumonia

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Protein S100B: from cancer diagnostics to the evaluation of mild traumatic brain injury
  4. Reviews
  5. Capillary electrophoresis based on nucleic acid detection for diagnosing human infectious disease
  6. Oxidative damage and the pathogenesis of menopause related disturbances and diseases
  7. Opinion Paper
  8. EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories
  9. Genetics and Molecular Diagnostics
  10. Effective quality management practices in routine clinical next-generation sequencing
  11. Analysis of PMP22 duplication and deletion using a panel of six dinucleotide tandem repeats
  12. A novel exonuclease (TaqMan) assay for rapid haptoglobin genotyping
  13. General Clinical Chemistry and Laboratory Medicine
  14. Heparinate but not serum tubes are susceptible to hemolysis by pneumatic tube transportation
  15. Criteria of adequacy for vitamin D testing and prevalence of deficiency in clinical practice
  16. A simple clot based assay for detection of procoagulant cell-derived microparticles
  17. Measurement of factor XIII (FXIII) activity by an automatic ammonia release assay using iodoacetamide blank-procedure: no more overestimation in the low activity range and better detection of severe FXIII deficiencies
  18. Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?
  19. Head to head evaluation of the analytical performance of two commercial methotrexate immunoassays and comparison with liquid chromatography-mass spectrometry and the former fluorescence polarization immunoassay
  20. Reference Values and Biological Variations
  21. Preanalytical, analytical, gestational and pediatric aspects of the S100B immuno-assays
  22. Establishment of reference intervals of clinical chemistry analytes for the adult population in Saudi Arabia: a study conducted as a part of the IFCC global study on reference values
  23. First data on the biological variation and quality specifications for plasma ammonia concentrations in healthy subjects
  24. Cancer Diagnostics
  25. Hypermethylation of DLX4 predicts poor clinical outcome in patients with myelodysplastic syndrome
  26. Cardiovascular Diseases
  27. Galectin-3, osteopontin and successful aging
  28. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
  29. Infectious Diseases
  30. Diagnostic values of CD64, C-reactive protein and procalcitonin in ventilator-associated pneumonia in adult trauma patients: a pilot study
  31. Corrigendum
  32. Corrigendum to: Accuracy of GFR estimating equations combining standardized cystatin C and creatinine assays: a cross-sectional study in Sweden
  33. Letters to the Editor
  34. Theranos phenomenon – part 3
  35. Biological variation of high sensitivity cardiac troponin-T in stable dialysis patients: implications for clinical practice
  36. Biological variation of high sensitivity cardiac troponin-T in stable dialysis patients: implications for clinical practice
  37. Impact of specimen mixing methods on presepsin point-of-care test results using whole blood
  38. Clinical laboratories have a critical role in test strip lot management in glucose point-of-care testing
  39. Hemoglobin A2-Leuven (α2δ2 143(H21) His>Asp): a novel delta-chain variant potentially interfering in hemoglobin A1c measurement using cation exchange HPLC
  40. Eryptosis is induced by hyperthermia in hereditary spherocytosis red blood cells
  41. Investigation of sensitivity for coagulation factor deficiency in APTT and PT: how to perform it?
  42. Underestimation of hepcidin concentration by time of flight mass spectrometry and competitive ELISA in hepcidin p.Gly71Asp heterozygotes
  43. Congress Abstracts
  44. ISMD2016 Eleventh International Symposium on Molecular Diagnostics
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