Nejvíce citovaný článek - PubMed ID 18946456
PURPOSE: Timely knowledge of the bacterial etiology and localization of infection are important for empirical antibiotic therapy. Thus, the goal of this study was to evaluate routinely used biomarkers together with novel laboratory parameters in the diagnosis of infection. METHODS: In this prospective study, 54 adult patients with bacterial infections admitted to the Department of Infectious Diseases were included. For comparison, 27 patients with viral infections were enrolled. In these patients, white blood cell (WBC) counts, differential blood counts, serum levels of procalcitonin (PCT), IL-1β, IL-6, IL-8, IL-10, IL-12, TNF-α, IFN-γ, soluble CD14 (sCD14), heparin-binding protein (HBP), cortisol (Cort), and monocyte surface expression of TLR2, TLR4, HLA-DR, and CD14 were analyzed. Also, these biomarkers were evaluated in 21 patients with acute community-acquired bacterial pneumonia (CABP), as well as in 21 patients with pyelonephritis and urosepsis. RESULTS: The highest sensitivity and specificity (expressed as the area under the curve [AUC]) for bacterial infection were observed in serum concentration of PCT (0.952), neutrophil and lymphocyte counts (0.852 and 0.841, respectively), and serum levels of HBP (0.837), IL-6 (0.830), and Cort (0.817). In addition, the serum levels of IFN-γ and Cort were significantly higher and IL-8 levels were lower in CABP when compared to pyelonephritis or urosepsis. CONCLUSIONS: From the novel potential biomarkers, only PCT demonstrated superiority over the routine parameters in the differentiation of bacterial from viral infections. However, some of the novel parameters should be further evaluated in larger and better characterized cohorts of patients in order to find their clinical applications.
- MeSH
- bakteriální infekce krev diagnóza MeSH
- biologické markery MeSH
- dospělí MeSH
- infekce získané v komunitě krev diagnóza MeSH
- kalcitonin * krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- močové ústrojí mikrobiologie MeSH
- peptid spojený s genem pro kalcitonin MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- proteinové prekurzory * krev MeSH
- pyelonefritida krev diagnóza MeSH
- senzitivita a specificita MeSH
- sepse krev diagnóza MeSH
- stupeň závažnosti nemoci MeSH
- virové nemoci krev diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- biologické markery MeSH
- CALCA protein, human MeSH Prohlížeč
- kalcitonin * MeSH
- peptid spojený s genem pro kalcitonin MeSH
- proteinové prekurzory * MeSH