title: Soluble Triggering Receptor Expressed on Myeloid cells-1 in bronchoalveolar lavage fluid is not predictive for ventilator-associated pneumonia.
abstract: OBJECTIVE
  Soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1) has proven to be a good biomarker for sepsis. For the diagnosis ventilator-associated pneumonia (VAP), however, there have only been a few, relatively small, studies on the role of this receptor. The aim of the study was to evaluate the usefulness of sTREM-1 in bronchoalveolar lavage fluid (BALF) from Intensive Care Unit patients as rapid diagnostic test for VAP.
  
  
  METHODS
  The concentration of sTREM-1 in 240 BALF samples was measured using a quantitative sandwich enzyme immunoassay. Two researchers who were blind to the assay results determined whether a VAP was present or not. Clinical suspicion of a VAP was confirmed by the presence of > or = 2% cells containing intracellular organisms and/or a quantitative culture result of > or = 10(4) colony forming units per millilitre BALF.
  
  
  RESULTS
  The mean concentration of sTREM-1 was significantly higher in the BALF of patients with confirmed VAP than in that of patients without confirmed VAP. However, the area under the receiver-operating characteristic curve was 0.58 (95% confidence interval 0.50-0.65, P = 0.04).
  
  
  CONCLUSIONS
  The results imply that the sTREM-1 assay in BALF may not be discriminative for VAP.
authors.affiliation: Department of Medical Microbiology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Oudhuis
authors.forename: Judith
authors.initials: J
authors.lastname: Beuving
authors.forename: Dennis
authors.initials: D
authors.lastname: Bergmans
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
authors.forename: Guul
authors.initials: G
authors.lastname: ten Velde
authors.forename: Catharina F
authors.initials: CF
authors.lastname: Linssen
authors.forename: Annelies
authors.initials: A
authors.lastname: Verbon