Sequential Measurements of Pentraxin 3 Serum Levels in Patients with Ventilator-Associated Pneumonia: A Nested Case-Control Study

Abstract EN

Purpose.

The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP).

Materials and Methods.

We designed a nested case-control study.

This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital.

Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study.

VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines.

Results.

The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults (p<0.05).

Procalcitonin and CRP levels did not significantly differ.

Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78).

Conclusions.

With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.