title: Characterization of nCD64 expression in neutrophils and levels of s-TREM-1 and HMGB-1 in patients with suspected infection admitted in an emergency department.
abstract: BACKGROUND
  The nCD64 receptor, the soluble triggering receptor expressed in myeloid cells (s-TREM-1), and the high mobility group-box 1 protein (HMGB-1) have been proposed as significant mediators in sepsis.
  
  
  OBJECTIVE
  To evaluate the prognostic value of these markers in patients with suspected infection recently admitted in an emergency department (ED).
  
  
  METHODS
  All patients who presented to the ED with suspected infection were eligible for enrollment in this study. Baseline clinical data, Sequential Organ Failure Assessment score (SOFA) score, APACHE II score, HMGB-1 levels, s-TREM-1 levels, and nCD64 levels were analyzed. The HMGB-1 and sTREM-1 serum concentrations were determined using commercially available ELISA kits, and CD64 on the surface of neutrophils was measured by flow cytometry.
  
  
  RESULTS
  . A total of 579 patients with suspected infection as their admission diagnosis were enrolled in this study. The median patient age was 50 years (IQR = 35-68). Morbidity during the 28-day followup period was 11.1% (n=64). The most frequent diagnosis at the time of admission was communityacquired pneumonia (CAP) in 23% (n=133) patients, followed by soft tissue infection in 16.6% (n=96), and urinary tract infection in 15% (n=87). After multivariable analysis, no significant association was identified between any biomarker and 28-day mortality.
  
  
  CONCLUSIONS
  In the context of a tertiary care hospital emergency department in a Latin-American city, the nCD64 receptor, s-TREM-1, and HMGB-1 biomarkers do not demonstrate prognostic utility in the management of patients with infection. The search continues for more reliable prognostic markers in the early stages of infection.
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Sergio
authors.initials: S
authors.lastname: Velásquez
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Juan D
authors.initials: JD
authors.lastname: Matute
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Laura Y
authors.initials: LY
authors.lastname: Gámez
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Enríquez
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Iván D
authors.initials: ID
authors.lastname: Gómez
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Toro
authors.affiliation: Departamento de Medicina Interna, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Valencia
authors.affiliation: Departamento de Cuidados Intensivos, Hospital Pablo Tobón Uribe, Medellín, Colombia.
authors.forename: Gisela
authors.initials: G
authors.lastname: De La Rosa
authors.affiliation: Grupo de Immunodeficiencias Primarias, Escuela de Medicina, Universidad de Antioquia.
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Patiño
authors.affiliation: Grupo Académico de Epidemiología Clínica (GRAEPIC), Escuela de Medicina, Universidad de Antioquia, Medellín, Colombia.
authors.forename: Fabián A
authors.initials: FA
authors.lastname: Jaimes
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D024002:HMGB Proteins; D024243:HMGB1 Protein / Q000097:blood*; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D009504:Neutrophils / Q000737:chemistry / Q000276:immunology*; D011379:Prognosis; D011446:Prospective Studies; D017452:Receptors, IgG / Q000032:analysis* / Q000096:biosynthesis*; D011971:Receptors, Immunologic / Q000097:blood*; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D024002:HMGB Proteins; D024243:HMGB1 Protein; C585491:HMGB1 protein, human; D008562:Membrane Glycoproteins; D017452:Receptors, IgG; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1