Bilgin Huseyin, Haliloglu Murat, Yaman Ali, Ay Pinar, Bilgili Beliz, Arslantas Mustafa Kemal, Ture Ozdemir Filiz, Haklar Goncagul, Cinel Ismail, Mulazimoglu Lutfiye
Infectious Diseases and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey.
Department of Anesthesiology and Intensive Care, Marmara University School of Medicine, Istanbul, Turkey.
Can J Infect Dis Med Microbiol. 2018 May 13;2018:4074169. doi: 10.1155/2018/4074169. eCollection 2018.
The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP).
We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study. VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines.
The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults ( < 0.05). Procalcitonin and CRP levels did not significantly differ. Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78).
With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.
本研究的主要目的是调查疑似呼吸机相关性肺炎（VAP）患者中，与降钙素原（PCT）和C反应蛋白（CRP）相比，五聚体3（PTX3）的动态变化。
我们设计了一项巢式病例对照研究。本研究在一所三级医疗学术大学和教学医院的外科重症监护病房进行。91名接受机械通气超过48小时的成年人纳入研究。根据2005年美国胸科学会/美国感染病学会指南，在28名患者中确诊为VAP。
VAP成年患者的PTX3血浆中位数水平为2.66 ng/mL，而非VAP成年患者为0.25 ng/mL（P<0.05）。降钙素原和CRP水平无显著差异。五聚体3以2.56 ng/mL为临界值，对VAP诊断的敏感性为85%，特异性为86%，阳性预测值为75%，阴性预测值为92.9%（曲线下面积=0.78）。
对于疑似VAP患者，五聚体3血浆临界值为2.56 ng/mL有助于决定是否开始使用抗生素。
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