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.
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.
|Titolo:||Biomarkers in pediatric community-acquired pneumonia|
TERRANOVA, LEONARDO (Primo)
ESPOSITO, SUSANNA (Ultimo)
|Data di pubblicazione:||16-nov-2016|
|Parole Chiave:||biomarker; CAP; children; community-acquired pneumonia; C reactive protein; MR-proADM; MR-proANP; procalcitonin; sTREM-1; white blood cell count|
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
|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.|
|Appare nelle tipologie:||14 - Intervento a convegno non pubblicato|