Combined biomarkers discriminate a low likelihood of bacterial infection among surgical intensive care unit patients with suspected sepsis.

TitleCombined biomarkers discriminate a low likelihood of bacterial infection among surgical intensive care unit patients with suspected sepsis.
Publication TypeJournal Article
Year of Publication2016
AuthorsKelly BJ, Lautenbach E, Nachamkin I, Coffin SE, Gerber JS, Fuchs BD, Garrigan C, Han X, Bilker WB, Wise JA, Tolomeo P, Han JH
Corporate AuthorsCenters for Disease Control and Prevention(CDC) Prevention Epicenters Program
JournalDiagn Microbiol Infect Dis
Date Published2016 Jan 8
ISSN1879-0070
Abstract

Among surgical intensive care unit (SICU) patients, it is difficult to distinguish bacterial sepsis from other causes of systemic inflammatory response syndrome (SIRS). Biomarkers have proven useful to identify the presence of bacterial infection. We enrolled a prospective cohort of 69 SICU patients with suspected sepsis and assayed the concentrations of 9 biomarkers (α-2 macroglobulin [A2M], C-reactive protein, ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) at baseline, 24, 48, and 72hours. Forty-two patients (61%) had bacterial sepsis by chart review. A2M concentrations were significantly lower, and PCT concentrations were significantly higher in subjects with bacterial sepsis at 3 of 4 time points. Using optimal cutoff values, the combination of baseline A2M and 72-hour PCT achieved a negative predictive value of 75% (95% confidence interval, 54-96%). The combination of A2M and PCT discriminated bacterial sepsis from other SIRS among SICU patients with suspected sepsis.

DOI10.1016/j.diagmicrobio.2016.01.003
Alternate JournalDiagn. Microbiol. Infect. Dis.
PubMed ID26971636
Grant ListK01 AI103028 / AI / NIAID NIH HHS / United States
K24 AI080942 / AI / NIAID NIH HHS / United States