Evaluation of potential biomarkers for the discrimination of bacterial and viral infections
Evaluation of potential biomarkers for the discrimination of bacterial and viral infections
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DOI：
10.1007/s15010-011-0126-4
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发表时间：
2011-10-01
期刊：
影响因子：
7.5
通讯作者：
Holub, M.
中科院分区：
文献类型：
--
作者：
Chalupa, P.;Beran, O.;Holub, M.
目的及时了解细菌病原学和感染部位对经验性抗生素治疗至关重要。因此，本研究的目的是评估常规使用的生物标志物连同新的实验室参数在诊断infection.Methods在这项前瞻性研究中，54例成人患者的细菌感染收治的传染病科。为了进行比较，入组了27例病毒感染患者。在这些患者中，分析了白色血细胞（WBC）计数、血细胞分类计数、降钙素原（PCT）、IL-1 β、IL-6、IL-8、IL-10、IL-12、TNF-α、IFN-γ、可溶性CD 14（sCD 14）、肝素结合蛋白（HBP）、皮质醇（Cort）的血清水平以及TLR 2、TLR 4、HLA-DR和CD 14的单核细胞表面表达。此外，这些生物标志物在21例急性社区获得性细菌性肺炎（CABP）患者以及21例肾盂肾炎和尿脓毒症患者中进行了评价。在PCT的血清浓度中观察到细菌感染的曲线下面积[AUC]（0.952）、中性粒细胞和淋巴细胞计数（分别为0.852和0.841）以及血清HBP（0.837）、IL-6（0.830）和Cort（0.817）水平。此外，IFN-γ和Cort的血清水平显着较高，IL-8水平较低，在CABP相比，肾盂肾炎或urosepsis.Conclusions从新的潜在的生物标志物，只有PCT表现出优越性的常规参数在区分细菌和病毒感染。然而，一些新的参数应该在更大和更好的患者队列中进一步评估，以找到它们的临床应用。
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-1 beta, IL-6, IL-8, IL-10, IL-12, TNF-alpha, IFN-gamma, 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 serumlevels of HBP (0.837), IL-6 (0.830), and Cort (0.817). In addition, the serum levels of IFN-gamma 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.