Plasma level of a triggering receptor expressed on myeloid cells-1: its diagnostic accuracy in patients with suspected sepsis
S Gibot, MN Kolopp-Sarda, MC Béné… - Annals of internal …, 2004 - acpjournals.org
Annals of internal medicine, 2004•acpjournals.org
Background: Previous experimental studies have suggested that the triggering receptor
expressed on myeloid cells-1 (TREM-1) is specifically upregulated in the presence of
microbial products. Objective: To evaluate the diagnostic value of plasma levels of the
soluble form of TREM-1 in patients admitted with clinical suspicion of infection. Design:
Prospective, noninterventional study conducted between July and September 2003. Setting:
Medical adult intensive care unit at a university hospital in France. Participants: 76 …
expressed on myeloid cells-1 (TREM-1) is specifically upregulated in the presence of
microbial products. Objective: To evaluate the diagnostic value of plasma levels of the
soluble form of TREM-1 in patients admitted with clinical suspicion of infection. Design:
Prospective, noninterventional study conducted between July and September 2003. Setting:
Medical adult intensive care unit at a university hospital in France. Participants: 76 …
Background
Previous experimental studies have suggested that the triggering receptor expressed on myeloid cells-1 (TREM-1) is specifically upregulated in the presence of microbial products.
Objective
To evaluate the diagnostic value of plasma levels of the soluble form of TREM-1 in patients admitted with clinical suspicion of infection.
Design
Prospective, noninterventional study conducted between July and September 2003.
Setting
Medical adult intensive care unit at a university hospital in France.
Participants
76 consecutive newly admitted patients who presented with clinically suspected infection and fulfilled at least 2 criteria of the systemic inflammatory response syndrome.
Measurements
Sensitivity and specificity of plasma soluble TREM-1 levels at admission for the diagnosis of infection. Two independent intensivists blinded to the results of soluble TREM-1 assays retrospectively classified patients as having the systemic inflammatory response syndrome, sepsis, severe sepsis, or septic shock.
Results
The systemic inflammatory response syndrome was diagnosed in 29 patients (38%), and sepsis, severe sepsis, or septic shock was diagnosed in the remaining 47 (62%). A plasma soluble TREM-1 level higher than 60 ng/mL was more accurate than any other clinical or laboratory finding for indicating infection (sensitivity, 96% [95% CI, 92% to 100%]; specificity, 89% [CI, 82% to 95%]; positive likelihood ratio, 8.6 [CI, 3.8 to 21.5]; negative likelihood ratio, 0.04 [CI, 0.01 to 0.2]).
Limitations
The study did not enroll patients with mild infections not requiring intensive care unit hospitalization, patients older than 80 years of age, or patients who were immunocompromised.
Conclusion
In newly admitted critically ill patients, measurement of plasma levels of soluble TREM-1 could help to rapidly identify those with infection.
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