Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
Int J Infect Dis. 2019 Oct;87:54-59. doi: 10.1016/j.ijid.2019.08.008. Epub 2019 Aug 13.
The epidemiology and role of the anti-PcrV titer in non-cystic fibrosis patients with Pseudomonas aeruginosa airway tract infections is not fully understood. This study was performed to compare the anti-PcrV titers of patients with and without P. aeruginosa respiratory tract infections.
This prospective cohort study was conducted at Hokkaido University Hospital in Japan. Participants had blood and sputum specimens collected on admission. They were divided into two groups based on their sputum culture results. Those with a P. aeruginosa infection were assigned to the P. aeruginosa (PA) group and those without a P. aeruginosa infection were assigned to the non-PA group. Serum anti-PcrV titers were measured using a validated ELISA.
Of the 44 participants, 15 were assigned to the PA group and 29 were assigned to the non-PA group. In the PA group, 10/15 participants (66.7%) had an anti-PcrV titer >1000ng/ml compared to 3/29 participants (10.3%) in the non-PA group (p<0.001). In the PA group, two of the five participants with an anti-PcrV titer <1000 ng/ml died of recurrent P. aeruginosa pneumonia; the other three participants did not develop pneumonia.
The anti-PcrV titers in participants with P. aeruginosa infection varied considerably. Patients with low anti-PcrV titers and refractory P. aeruginosa infections need to be monitored closely.
非囊性纤维化患者铜绿假单胞菌气道感染的流行病学和抗 PcrV 效价的作用尚不完全清楚。本研究旨在比较铜绿假单胞菌呼吸道感染患者与非感染患者的抗 PcrV 效价。
本前瞻性队列研究在日本北海道大学医院进行。参与者入院时采集血液和痰标本。根据痰培养结果将他们分为两组。有铜绿假单胞菌感染的患者被分配到铜绿假单胞菌(PA)组,没有铜绿假单胞菌感染的患者被分配到非 PA 组。使用经过验证的 ELISA 测量血清抗 PcrV 效价。
在 44 名参与者中,15 名被分配到 PA 组,29 名被分配到非 PA 组。在 PA 组中,10/15 名患者(66.7%)的抗 PcrV 效价>1000ng/ml,而在非 PA 组中,3/29 名患者(10.3%)的抗 PcrV 效价>1000ng/ml(p<0.001)。在 PA 组中,5 名抗 PcrV 效价<1000ng/ml 的患者中有 2 人死于复发性铜绿假单胞菌肺炎;另外 3 名患者未发生肺炎。
铜绿假单胞菌感染患者的抗 PcrV 效价差异很大。抗 PcrV 效价低且难治性铜绿假单胞菌感染的患者需要密切监测。