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

1.	胡付品, 郭燕, 朱德妹, 等. 2016 年中國 CHINET 細菌耐藥性監測. 中國感染與化療雜志, 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.	中華醫學會呼吸病學分會感染學組. 中國成人醫院獲得性肺炎與呼吸機相關性肺炎診斷和治療指南(2018 年版). 中華結核和呼吸雜志, 2018, 41(4): 255-280.
5.	中華醫學會呼吸病學分會介入呼吸病學學組. 成人診斷性可彎曲支氣管鏡檢查術應用指南(2019 年版). 中華結核和呼吸雜志, 2019, 42(8): 573-590.
6.	宋娟, 華川. 下呼吸道標本分離鮑曼不動桿菌: 感染還是定植?. 中國感染控制雜志, 2016, 15(12): 974-977.
7.	盧惠倫, 游世倫, 李立波. 可溶性髓樣細胞觸發受體-1 在慢性阻塞性肺疾病患者下呼吸道細菌感染中的診斷價值. 實用醫學雜志, 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.	Siranovi? M, Kovac J, Gopcevi? 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.	馮霞, 江利冰, 馬岳峰, 等. 降鈣素原和血漿可溶性髓樣細胞觸發受體 1 診斷呼吸機相關性肺炎的比較: Meta 分析. 中國呼吸與危重監護雜志, 2015, 14(1): 36-41.
16.	李健球, 熊旭明, 陳望, 等. 支氣管肺泡灌洗液可溶性髓樣細胞觸發受體 1 對創傷后急性呼吸窘迫綜合征患者肺部感染的早期診斷價值. 中國呼吸與危重監護雜志, 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.	楊鈞, 王海燕, 梁慧, 等. 機械通氣患者下呼吸道細菌定植導致呼吸機相關性肺炎危險因素的前瞻性研究. 中國呼吸與危重監護雜志, 2013, 12(3): 253-257.

1. 胡付品, 郭燕, 朱德妹, 等. 2016 年中國 CHINET 細菌耐藥性監測. 中國感染與化療雜志, 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. 中華醫學會呼吸病學分會感染學組. 中國成人醫院獲得性肺炎與呼吸機相關性肺炎診斷和治療指南(2018 年版). 中華結核和呼吸雜志, 2018, 41(4): 255-280.
5. 中華醫學會呼吸病學分會介入呼吸病學學組. 成人診斷性可彎曲支氣管鏡檢查術應用指南(2019 年版). 中華結核和呼吸雜志, 2019, 42(8): 573-590.
6. 宋娟, 華川. 下呼吸道標本分離鮑曼不動桿菌: 感染還是定植?. 中國感染控制雜志, 2016, 15(12): 974-977.
7. 盧惠倫, 游世倫, 李立波. 可溶性髓樣細胞觸發受體-1 在慢性阻塞性肺疾病患者下呼吸道細菌感染中的診斷價值. 實用醫學雜志, 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. Siranovi? M, Kovac J, Gopcevi? 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. 馮霞, 江利冰, 馬岳峰, 等. 降鈣素原和血漿可溶性髓樣細胞觸發受體 1 診斷呼吸機相關性肺炎的比較: Meta 分析. 中國呼吸與危重監護雜志, 2015, 14(1): 36-41.
16. 李健球, 熊旭明, 陳望, 等. 支氣管肺泡灌洗液可溶性髓樣細胞觸發受體 1 對創傷后急性呼吸窘迫綜合征患者肺部感染的早期診斷價值. 中國呼吸與危重監護雜志, 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. 楊鈞, 王海燕, 梁慧, 等. 機械通氣患者下呼吸道細菌定植導致呼吸機相關性肺炎危險因素的前瞻性研究. 中國呼吸與危重監護雜志, 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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