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Usefulness of consecutive biomarkers measurement in the management of community-acquired pneumonia

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Abstract

The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiological diagnosis of pneumonia. Serum samples were collected at admission and during hospitalization. Complications were defined as intensive care unit (ICU) admission or death. The levels of PCT were significantly higher in pneumonia of definite bacterial origin in comparison to probable bacterial or unknown origin. The PCT levels were higher in pneumococcal pneumonia. The PCT and MR-proANP levels increased significantly according to the Pneumonia Severity Index (PSI). All biomarkers levels are higher in patients developing complications and who were dying. The serial levels of MR-proANP remain significantly elevated in patients developing complications and in patients classified in PSI and CURB-65 risk groups. In patients not developing complications, there is a significant decrease in the PCT levels. PCT can be useful for identifying pneumonia etiology. PCT and MR-proANP levels correlate with pneumonia severity rules. PCT and MR-proANP serial measurements can be useful for predicting short-term prognosis. Systemic biomarkers can provide additional information regarding clinical evolution, because these are dynamic and can be measured daily.

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Acknowledgments

We thank R. Menéndez for providing us with the computerized database from the patients included at Hospital Universitari Germans Trias i Pujol in the framework of NAC-CALIDAD project of the “Sociedad Española de Neumología y Cirugía Torácica” (SEPAR). We also thank the Microbiology Laboratory technicians of the Hospital Universitari Germans Trias i Pujol and Oriol Martos for the technical assistance. Statistical analysis was performed at the Statistics Service (Universitat Autònma de Barcelona) by O. Valero. J. Domínguez is a researcher of the “Miguel Servet” program of the Instituto de Salud Carlos III (Spain).

Conflicts of interest disclosure

No company had a role in the design or conducting of the study, collection, management, or interpretation of the data, preparation, review, or approval of this manuscript. The authors have no conflict of interest, including specific financial interests or relationships or affiliations to the subject matter or materials discussed in the manuscript.

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Authors and Affiliations

  1. Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Barcelona, Spain

    A. Lacoma, C. Prat, A. Ramírez, A. Bas, M. Pérez, V. Ausina & J. Domínguez

  2. Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Barcelona, Spain

    N. Rodríguez, J. Ruiz-Manzano & F. Andreo

  3. CIBER Enfermedades Respiratorias (CIBERES) Instituto de Salud Carlos III, Badalona, Barcelona, Spain

    A. Lacoma, C. Prat, J. Ruiz-Manzano, F. Andreo, V. Ausina & J. Domínguez

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  1. A. Lacoma
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  8. M. Pérez
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  9. V. Ausina
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  10. J. Domínguez
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Lacoma, A., Rodríguez, N., Prat, C. et al. Usefulness of consecutive biomarkers measurement in the management of community-acquired pneumonia. Eur J Clin Microbiol Infect Dis 31, 825–833 (2012). https://doi.org/10.1007/s10096-011-1381-0

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