Data di Pubblicazione:
2016
Citazione:
Biomarkers in pediatric community-acquired pneumonia / L. Terranova, L. Ruggiero, N. Principi, S. Esposito. ((Intervento presentato al convegno Terza giornata della ricerca tenutosi a Milano nel 2016.
Abstract:
Background: Aim of this study was to evaluate the predictive capacity of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), midregional proatrial natriuretic peptide (MR-proANP) and midregional proadrenomedullin (MR-proADM) in a group of children hospitalized for radiologically confirmed community-acquired pneumonia (CAP).
Methods: White blood cell counts, neutrophil percentages and serum C reactive protein (CRP) levels were determined using routine methods. sTREM-1 concentrations were measured using an ELISA; MR-proADM, MR-proANP and procalcitonin (PCT) were measured with an automated immunofluorescent assay. Viral DNA or RNA was extracted using a Nuclisens EasyMAG automated extraction system and tested using the Luminex x TAG Respiratory Virus Panel Fast Assay. To detect pneumococcal cases, nucleic acid
extracts from blood and swab samples were tested for two genes of Streptococcus pneumoniae using real-time PCR. Mycoplasma pneumoniae was detected with nested PCR.
Results: A total of 433 children with radiologically confirmed CAP were enrolled. CAP was ascribed to bacteria in 235 (54.3%) children and to one or more viruses in 111 (25.6%). CRP and PCT had the best performances for both bacterial and viral CAP identification. The cut-off values with the highest combined sensitivity and specificity for the identification of bacterial and viral infections using CRP were ≥7.98 mg/L and ≤7.5 mg/L, respectively. When PCT was considered, the cut-off values with the highest combined sensitivity and specificity were ≥0.188 ng/mL for bacterial CAP and ≤0.07 ng/mL for viral CAP. For the
identification of severe cases, the best results were obtained with evaluations of PCT and MR-proANP. However, in both cases, the biomarker cut-off with the highest combined sensitivity and specificity (≥0.093 ng/mL for PCT and ≥33.8 pmol/L for proANP) had a relatively good sensitivity (higher than 70%) but a limited specificity (of approximately 55%).
Conclusion: In children with CAP, sTREM-1, MR-proANP, and MR-proADM blood levels have poor abilities to differentiate bacterial from viral diseases or to identify severe cases, whereas PCT represents the most important biomarker at this regard.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Keywords:
biomarker; CAP; children; community-acquired pneumonia; C reactive protein; MR-proADM; MR-proANP; procalcitonin; sTREM-1; white blood cell count
Elenco autori:
L. Terranova, L. Ruggiero, N. Principi, S. Esposito
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