title: Is mid-regional pro-atrial natriuretic peptide (MRproANP) an accurate marker of bacteremia in pyelonephritis?
abstract: BACKGROUND
  Mid-regional pro-atrial natriuretic peptide (MRproANP) increases during systemic infections and could possibly correlate with bacteremia.
  
  
  METHODS
  We determined the characteristics of MRproANP for accuracy to detect positive blood culture.
  
  
  RESULTS
  Bacteremia was positive in 58 (15%) of 347 patients. MRproANP levels increased in patients with bacteremia (98.4 pmol/L [interquartile range (IQR) 68.2-153.1] vs. 66.4 pmol/L [IQR 51.0-90.3], p <0.01). Performance of MRproANP to predict bacteremia [AUC = 0.69, 95%CI: 0.61-0.77] was equivalent to C-reactive protein (0.66 [95%CI: 0.59-0.74], p = 0.53) but less accurate than procalcitonin (0.78 [95%CI: 0.72-0.84], p <0.001).
  
  
  CONCLUSIONS
  Although MRproANP increased in bacteremic patients with acute pyelonephritis, results of likelihood ratios discarded its use at bedside to predict bacteremia.
authors: Department of Emergency Medicine, Groupe Hospitalier Broca Cochin Hôtel-Dieu, Paris Cedex 14, France.
authors: Solweig
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authors: Guinard-Barbier
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