sTREM-1 and LBP in central venous catheter-associated bloodstream infections in pediatric intestinal failure.
J Pediatr Gastroenterol Nutr
; 53(6): 627-33, 2011 Dec.
Article
em En
| MEDLINE
| ID: mdl-21701408
ABSTRACT
OBJECTIVE:
Central venous catheter-associated bloodstream infections (CVC-BSIs) are a major cause of morbidity and mortality in the pediatric intestinal failure (IF) population. We assessed plasma lipopolysaccharide-binding protein (LBP) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as biomarkers for CVC-BSI. We hypothesized that sTREM-1 and LBP rise with BSI and decline following treatment, and that baseline LBP is higher in the IF population than in controls. PATIENTS ANDMETHODS:
Patients younger than 4 years were recruited from the IF registry at Cincinnati Children's Hospital. LBP and sTREM-1 levels were measured on 22 patients with IF at baseline, 17 patients with IF with BSIs, and 11 healthy controls.RESULTS:
Mean sTREM-1 level (pg/mL) and LBP level (µg/mL) rose with CVC-BSI over baseline (115.0â±â51.2 vs 85.9â±â27.6, Pâ=â0.011 and 79.8â±â45.4 vs 20.5â±â11.3, Pâ<â0.001, respectively) and declined following antibiotic therapy (115.0â±â51.2 vs 77.9â±â29.8, Pâ=â0.003 and 79.8â±â45.4 vs 26.2â±â10.8, Pâ<â0.001, respectively). Receiver operating characteristic curves showed that neither sTREM-1 nor LBP is sufficient to predict bacteremia versus fever without bacteremia (area under these curvesâ=â0.57 and 0.82, respectively). Baseline LBP was higher in hospitalized patients than in outpatients (27.5â±â8.7 vs 13.5â±â9.2, Pâ=â0.002), patients with previous BSIs versus those without (23.5â±â10.4 vs 10.1â±â8.3, Pâ=â0.016), and those listed for transplantation versus those not listed (29.6â±â9.8 vs 16.2â±â9.5, Pâ=â0.033).CONCLUSIONS:
sTREM-1 and LBP rise with CVC-BSI in IF and decline after treatment; however, neither distinguishes infection from nonbacteremic febrile episodes. Baseline LBP may be a marker of disease severity in IF.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Venoso Central
/
Glicoproteínas de Membrana
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Receptores Imunológicos
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Proteínas de Transporte
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Bacteriemia
/
Intestinos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos