Diagnostic value of soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid for <i>Acinetobacter baumannii</i> infection and colonization in the lungs_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

TAN Jianlong , LIU Zhiguang , DENG Hongying , LI Jianming ,  ZHANG Weidong

Department of Respiratory Medicine, Hunan Provincial Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, P. R. China;

Corresponding author：

ZHANG Weidong, Email: 700816@sina.com

Keywords：

Acinetobacter baumannii; Soluble triggering receptor expressed on myeloid cells-1; Bronchoalveolar lavage fluid; Pulmonary infection; Colonization

DOI：

10.7507/1671-6205.201910087

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Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) level in bronchoalveolar lavage fluid (BALF) for discrimination of Acinetobacter baumannii (A. baumannii) colonization from infection.Methods Sixty patients with tracheal intubation or tracheotomy who were admitted in intensive care unit from July 2016 to July 2018, were divided into an infection group (n=20), a colonization group (n=20) and a control group (n=20). The serum and BALF samples were collected from the patients on the day when lower respiratory tract sample culture was positive so as to detect sTREM-1, serum procalcitonin (PCT) and interleukin-6 (IL-6). The value of serum PCT, IL-6, sTREM-1 and BALF sTREM-1 in differentiation of infection or colonization for A. baumannii was analyzed by mean of receiver operating characteristic (ROC) curve.Results There were no significant differences in gender composition, age or Glasgow coma score among the three groups (P>0.05). The clinical pulmonary infection score (CPIS) of the infection group was higher than that in the control group (P<0.05). Compared with the control group, while the sTREM-1 concentration of BALF with A. baumannii colonization increased significantly but levels of PCT, IL-6 and sTREM-1 remained unchanged in serum. The levels of PCT, IL-6 and sTREM-1 in serum, and sTREM-1 in BALF increased significantly in the infection group (P<0.001). Compared with the colonization group, the levels of PCT, IL-6 and sTREM-1 in serum, and sTREM-1 in BALF increased significantly in the infection group (P<0.05). The area under the ROC curve (AUC) of serum PCT was 0.67 with the sensitivity of 0.55 and the specificity of 0.90 (95%CI 0.52 - 0.82). AUC of serum IL-6 was 0.72 with the sensitivity of 0.60 and the specificity of 0.95 (95%CI 0.58 - 0.85). AUC of serum sTREM-1 was 0.72 with the sensitivity of 0.75 and the specificity of 0.60 (95%CI 0.55 - 0.85). AUC of sTREM-1 in BALF was 0.92 with the sensitivity of 0.95 and the specificity of 0.70 (95%CI 0.79 - 0.98). The diagnostic accuracy of sTREM-1 in BALF was higher than that of PCT, IL-6 and sTREM-1 in serum (P<0.05).Conclusions sTREM-1 in BALF has good diagnostic performance in differentiating patients with infection of colonization for A. baumannii. Its sensitivity and specificity are higher than serum PCT, IL-6 and sTREM-1.

Citation： TAN Jianlong, LIU Zhiguang, DENG Hongying, LI Jianming, ZHANG Weidong. Diagnostic value of soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid for Acinetobacter baumannii infection and colonization in the lungs. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(5): 446-450. doi: 10.7507/1671-6205.201910087 Copy

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2.	Lee H, Lee H. Clinical and economic evaluation of multidrug-resistant Acinetobacter baumannii colonization in the intensive care unit. Infect Chemother, 2016, 48(3): 174-180.
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7.	卢惠伦, 游世伦, 李立波. 可溶性髓样细胞触发受体-1 在慢性阻塞性肺疾病患者下呼吸道细菌感染中的诊断价值. 实用医学杂志, 2013, 29(13): 3-2125.
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10.	Michel CS, Teschner D, Wagner EM, et al. Diagnostic value of sTREM-1, IL-8, PCT, and CRP in febrile neutropenia after autologous stem cell transplantation. Ann Hematol, 2017, 96(12): 2095-2101.
11.	Yu Y, Zhu C, Liu C, et al. Diagnostic performance of soluble triggering receptor expressed on myeloid cells-1 in ventilator-associated pneumonia of patients with ischemic stroke. Can J Infect Dis Med Microbiol, 2017, 2017: 9513690.
12.	Siranović M, Kovac J, Gopcević S, et al. Human soluble TREM-1: lung and serum levels in patients with bacterial ventilator associated pneumonia. Acta Clin Croat, 2011, 50(3): 345-349.
13.	Grover V, Pantelidis P, Soni N, et al. A biomarker panel (Bioscore) incorporating monocytic surface and soluble TREM-1 has high discriminative value for ventilator-associated pneumonia: a prospective observational study. PLoS One, 2014, 9(10): e109686.
14.	Hu C, Jiang J, Li Z, et al. Expression pattern of soluble triggering receptor expressed on myeloid cells-1 in mice with Acinetobacter baumannii colonization and infection in the lung. J Thorac Dis, 2018, 10(3): 1614-1621.
15.	冯霞, 江利冰, 马岳峰, 等. 降钙素原和血浆可溶性髓样细胞触发受体 1 诊断呼吸机相关性肺炎的比较: Meta 分析. 中国呼吸与危重监护杂志, 2015, 14(1): 36-41.
16.	李健球, 熊旭明, 陈望, 等. 支气管肺泡灌洗液可溶性髓样细胞触发受体 1 对创伤后急性呼吸窘迫综合征患者肺部感染的早期诊断价值. 中国呼吸与危重监护杂志, 2014, 13(3): 241-245.
17.	Raveendran AV, Kumar A, Gangadharan S. Biomarkers and newer laboratory investigations in the diagnosis of sepsis. J R Coll Physicians Edinb, 2019, 49(3): 207-216.
18.	杨钧, 王海燕, 梁慧, 等. 机械通气患者下呼吸道细菌定植导致呼吸机相关性肺炎危险因素的前瞻性研究. 中国呼吸与危重监护杂志, 2013, 12(3): 253-257.

1. 胡付品, 郭燕, 朱德妹, 等. 2016 年中国 CHINET 细菌耐药性监测. 中国感染与化疗杂志, 2017, 17(5): 481-491.
2. Lee H, Lee H. Clinical and economic evaluation of multidrug-resistant Acinetobacter baumannii colonization in the intensive care unit. Infect Chemother, 2016, 48(3): 174-180.
3. Villar M, Cano ME, Gato E, et al. Epidemiologic and clinical impact of Acinetobacter baumannii colonization and infection: a reappraisal. Medicine (Baltimore), 2014, 93(5): 202-210.
4. 中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018 年版). 中华结核和呼吸杂志, 2018, 41(4): 255-280.
5. 中华医学会呼吸病学分会介入呼吸病学学组. 成人诊断性可弯曲支气管镜检查术应用指南(2019 年版). 中华结核和呼吸杂志, 2019, 42(8): 573-590.
6. 宋娟, 华川. 下呼吸道标本分离鲍曼不动杆菌: 感染还是定植?. 中国感染控制杂志, 2016, 15(12): 974-977.
7. 卢惠伦, 游世伦, 李立波. 可溶性髓样细胞触发受体-1 在慢性阻塞性肺疾病患者下呼吸道细菌感染中的诊断价值. 实用医学杂志, 2013, 29(13): 3-2125.
8. Tufvesson E, Markstad H, Bozovic G, et al. Inflammation and chronic colonization of Haemophilus influenzae in sputum in COPD patients related to the degree of emphysema and bronchiectasis in high-resolution computed tomography. Int J Chron Obstruct Pulmon Dis, 2017, 12: 3211-3219.
9. Borekci S, Halis AN, Aygun G, et al. Bacterial colonization and associated factors in patients with bronchiectasis. Ann Thorac Med, 2016, 11(1): 55-59.
10. Michel CS, Teschner D, Wagner EM, et al. Diagnostic value of sTREM-1, IL-8, PCT, and CRP in febrile neutropenia after autologous stem cell transplantation. Ann Hematol, 2017, 96(12): 2095-2101.
11. Yu Y, Zhu C, Liu C, et al. Diagnostic performance of soluble triggering receptor expressed on myeloid cells-1 in ventilator-associated pneumonia of patients with ischemic stroke. Can J Infect Dis Med Microbiol, 2017, 2017: 9513690.
12. Siranović M, Kovac J, Gopcević S, et al. Human soluble TREM-1: lung and serum levels in patients with bacterial ventilator associated pneumonia. Acta Clin Croat, 2011, 50(3): 345-349.
13. Grover V, Pantelidis P, Soni N, et al. A biomarker panel (Bioscore) incorporating monocytic surface and soluble TREM-1 has high discriminative value for ventilator-associated pneumonia: a prospective observational study. PLoS One, 2014, 9(10): e109686.
14. Hu C, Jiang J, Li Z, et al. Expression pattern of soluble triggering receptor expressed on myeloid cells-1 in mice with Acinetobacter baumannii colonization and infection in the lung. J Thorac Dis, 2018, 10(3): 1614-1621.
15. 冯霞, 江利冰, 马岳峰, 等. 降钙素原和血浆可溶性髓样细胞触发受体 1 诊断呼吸机相关性肺炎的比较: Meta 分析. 中国呼吸与危重监护杂志, 2015, 14(1): 36-41.
16. 李健球, 熊旭明, 陈望, 等. 支气管肺泡灌洗液可溶性髓样细胞触发受体 1 对创伤后急性呼吸窘迫综合征患者肺部感染的早期诊断价值. 中国呼吸与危重监护杂志, 2014, 13(3): 241-245.
17. Raveendran AV, Kumar A, Gangadharan S. Biomarkers and newer laboratory investigations in the diagnosis of sepsis. J R Coll Physicians Edinb, 2019, 49(3): 207-216.
18. 杨钧, 王海燕, 梁慧, 等. 机械通气患者下呼吸道细菌定植导致呼吸机相关性肺炎危险因素的前瞻性研究. 中国呼吸与危重监护杂志, 2013, 12(3): 253-257.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value of soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid for Acinetobacter baumannii infection and colonization in the lungs

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