title: Diagnostic utility of the soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid from patients with bilateral lung infiltrates.
abstract: BACKGROUND
  Differential diagnosis of patients with bilateral lung infiltrates remains a difficult problem for intensive care clinicians. Here we evaluate the diagnostic role of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in bronchoalveolar lavage (BAL) specimens from patients with bilateral lung infiltrates.
  
  
  METHODS
  We conducted a prospective observational study on 80 patients with bilateral lung infiltrates with clinical suspicion of infectious pneumonia. Patients were categorized into three groups: bacterial or fungal infection, intracellular or viral infection, and noninfectious inflammatory disease. sTREM-1 concentrations were measured, and BAL fluid and Clinical Pulmonary Infection Score (CPIS) were analyzed.
  
  
  RESULTS
  The sTREM-1 concentration was significantly increased in patients with bacterial or fungal pneumonia (n = 29, 521.2 +/- 94.7 pg/ml), compared with that in patients with viral pneumonia, atypical pneumonia or tuberculosis (n = 14, 92.9 +/- 20.0 pg/ml) or noninfectious inflammatory disease (n = 37, 92.8 +/- 10.7 pg/ml). The concentration of sTREM-1 in BAL fluid, but not CPIS, was an independent predictor of bacterial or fungal pneumonia, and a cutoff value of more than 184 pg/ml yielded a diagnostic sensitivity of 86% and a specificity of 90%.
  
  
  CONCLUSIONS
  The sTREM-1 level in BAL fluid from patients with bilateral lung infiltrates is a potential marker for the differential diagnosis of pneumonia due to extracellular bacteria.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Ilsan Paik Hospital, Inje University, 2240, Daehwa-dong, Ilsanseo-gu, Goyang-si, Gyeonggi-do, 411-706, Korea.
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Huh
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
authors.forename: Yeon Mok
authors.initials: YM
authors.lastname: Oh
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Shim
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Lee
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Dong Soon
authors.initials: DS
authors.lastname: Kim
authors.forename: Won Dong
authors.initials: WD
authors.lastname: Kim
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Hong
mesh_terms: D015415:Biomarkers; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008562:Membrane Glycoproteins; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis*; D012372:ROC Curve; D011971:Receptors, Immunologic; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1