Combined biomarkers discriminate a low likelihood of bacterial infection among surgical intensive care unit patients with suspected sepsis

Details

• Alternative Title:
  Diagn Microbiol Infect Dis
• Personal Author:
  Kelly, Brendan J. ; Lautenbach, Ebbing ; Nachamkin, Irving ; Coffin, Susan E. ; Gerber, Jeffrey S. ; Fuchs, Barry D. ; Garrigan, Charles ; Han, Xiaoyan ; Bilker, Warren B. ; Wise, Jacqueleen ; Tolomeo, Pam ; Han, Jennifer H.
• Corporate Authors:
  for the Centers for Disease Control and Prevention (CDC) Prevention Epicenters Program
• Description:
  Among surgical intensive care unit (SICU) patients, it is difficult to distinguish bacterial sepsis from other causes of systemic inflammatory response syndrome (SIRS). Biomarkers have proven useful to identify the presence of bacterial infection. We enrolled a prospective cohort of 69 SICU patients with suspected sepsis and assayed the concentrations of 9 biomarkers (α-2 macroglobulin [A2M], C-reactive protein, ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) at baseline, 24, 48, and 72hours. Forty-two patients (61%) had bacterial sepsis by chart review. A2M concentrations were significantly lower, and PCT concentrations were significantly higher in subjects with bacterial sepsis at 3 of 4 time points. Using optimal cutoff values, the combination of baseline A2M and 72-hour PCT achieved a negative predictive value of 75% (95% confidence interval, 54-96%). The combination of A2M and PCT discriminated bacterial sepsis from other SIRS among SICU patients with suspected sepsis.
• Subjects:
  Adult Aged Aged, 80 And Over Article Bacteremia Biomarkers Cross Infection Diagnosis, Differential Humans Intensive Care Units Middle Aged ROC Curve Sepsis Systemic Inflammatory Response Syndrome

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• Source:
  Diagn Microbiol Infect Dis. 85(1):109-115
• Pubmed ID:
  26971636
• Pubmed Central ID:
  PMC4841711
• Document Type:
  Journal Article
• Funding:
  K24 AI080942/AI/NIAID NIH HHS/United States ; K01-AI103028/AI/NIAID NIH HHS/United States ; FOA#CK11-001/CK/NCEZID CDC HHS/United States ; U54 CK000163/CK/NCEZID CDC HHS/United States ; K01 AI103028/AI/NIAID NIH HHS/United States
• Volume:
  85
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f2043c032086e8e3527017d827d97c045c770684a43813367b6d977a33bf60f1
• Download URL:
  https://stacks.cdc.gov/view/cdc/39060/cdc_39060_DS1.pdf
• File Type:
  [PDF - 1.43 MB ]