戊霉素3在机械通气患者感染早期诊断中的临床应用

Mona T Fadel, D. Magdy, R. Ahmed, Amal Hosni
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摘要

呼吸机相关性肺炎(VAP)是最常见的icu获得性感染之一;然而,它的诊断仍然是一个挑战。目的评价戊曲霉素3 (PTX3)在VAP早期诊断中的价值。患者和方法在2019年1月1日至2021年12月期间,45名接受机械通气超过48小时并发生VAP的成年患者入组了埃及Assiut大学医院的这项纵向描述性医院研究。VAP的诊断取决于培养阳性,以及临床肺部感染评分大于或等于7分。为了测量PTX3水平,在气管插管第一天采集第一个样本,在发生VAP的患者第3天采集第二次样本。结果入组患者平均年龄为55.98±14.54岁(30 ~ 80岁)。总的来说,60%是男性,40%是女性。最常见的病原菌为铜绿假单胞菌,其次为金黄色葡萄球菌。在随访期间,只有PTX3有显著升高,而在随访期间,红细胞沉降率(ESR)和c反应蛋白(CRP)均无显著差异。此外,PTX3与CRP有显著正相关;然而,它与ESR没有相关性,而CRP与ESR有显著的正相关。结论PTX3作为诊断VAP患者及疾病进展随访的生物标志物优于ESR和CRP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The clinical utility of pentraxin 3 for the early diagnosis of infection in mechanically ventilated patients
Background Ventilator-associated pneumonia (VAP) is one of the most common ICU-acquired infections; however, its diagnosis is still a challenge. Objectives To evaluate the diagnostic performance of pentraxin 3 (PTX3) in early detection of patients with VAP. Patients and methods In the period from the first of January 2019 up to December 2021, 45 adult patients who underwent mechanical ventilation more than 48 h and developed VAP were enrolled in this longitudinal descriptive hospital-based study, Assiut University Hospital, Assiut, Egypt. Diagnosis of VAP depends on positive culture, in addition to a clinical pulmonary infection score more than or equal to 7. To measure the level of PTX3, the first sample was taken on the first day of the endotracheal intubation, and the second sample was taken on the third day from the patients who developed VAP. Results The study showed that the mean age of enrolled patients was 55.98 ± 14.54 years (range, 30–80 years). Overall, 60% were males and 40% were females. The most common causative pathogen was Pseudomonas aeruginosa, followed by Staphylococcus aureus. Only PTX3 showed significant increase during follow-up, whereas no significant difference was observed in either erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) during the follow-up period. Moreover, it was observed that PTX3 had a significant positive correlation with CRP; however, it did not show correlation with ESR, whereas CRP had a significant positive correlation with ESR. Conclusions PTX3 was superior to both ESR and CRP as a biomarker to diagnose patients with VAP and also for follow-up of disease progression.
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