Combination of biomarkers for the discrimination between bacterial and viral lower respiratory tract infections

Item does not contain fulltextOBJECTIVES: To investigate whether additional determinations of plasma lipopolysaccharide binding protein (LBP), procalcitonin (PCT), interleukin-6 (IL-6), IL-18, or soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) to C-reactive protein (CRP) improve the discrimination between bacterial and viral lower respiratory tract infections (LRTI). METHODS: Out of 342 patients visiting the emergency department because of a suspected infection and >/=2 clinical signs of sepsis, 56 patients with proven bacterial (n = 39) or viral (n = 17) LRTI were included. The area under the ROC curves (AUC) of the five possible combinations of CRP with one other biomarker were compared with the AUC of CRP alone. Next, the same analysis was performed in the group of patients with a CRP concentration with 150 mg/l, biomarker panel analyses did not improve diagnostic accuracy of CRP either. CONCLUSIONS: Combining CRP with LBP, PCT, IL-6, IL-18, or sTREM-1 does not improve differentiation between patients with a bacterial or viral LRTI compared with CRP alone