Soluble triggering receptor expressed on myeloid cells-1 is an early marker of infection in the surgical intensive care unit.
BACKGROUND
To determine the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in early differentiation of systemic inflammatory response syndrome (SIRS) from infection in patients in a surgical intensive care unit (ICU).


METHODS
Patients were enrolled if there was clinical suspicion of infection and they fulfilled at least two criteria of SIRS at the time of admission to the ICU. The patients were classified as having SIRS (no infection; n = 37) or infection (n = 56) on the basis of the decision of the treating physician and bacteriological evidence of infection. The plasma concentrations of sTREM-1 in the two groups were compared.


RESULTS
Patients with infection had significantly higher sTREM-1 concentrations than patients with SIRS: Median 398 pg/mL (interquartile range [IQR] 302, 552) vs. 78 pg/mL (IQR 28, 150), respectively (p < 0.0001). At a cut-off of 230 pg/mL, sTREM-1 correctly identified patients suffering from infection with 96% sensitivity and 91% specificity.


CONCLUSIONS
In the present study, sTREM-1 was an accurate tool for differentiating SIRS from infection in patients in the surgical ICU.
Department of Surgery-Burn/Trauma/Critical Care, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9158, USA. fernando.rivera@utsouthwestern.edu
Fernando A
FA
Rivera-Chavez
Joseph P
JP
Minei
D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000378:metabolism*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D022423:Myeloid Cells / Q000378:metabolism*; D012680:Sensitivity and Specificity; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000378:metabolism*
D015415:Biomarkers