The Value of sTREM-1, PCT, and CRP as Markers for the Detection of Sepsis and Bacteremia Among Patients With a FUO
The Value of sTREM-1, PCT, and CRP as Markers for the Detection of Sepsis and Bacteremia Among Patients With a FUO
The investigators enrolled 144 subjects admitted to ICUs: 60 patients with systemic
 inflammatory response syndrome (SIRS) and 84 patients with sepsis. Tests for serum sTREM-1,
 PCT, and CRP levels and blood culture were performed on the day of admission and with the
 occurrence of FUO (>38.3ºC) during hospitalization. Based on the results of blood culture,
 the subjects were divided into bacteremia (33 patients) and non-bacteremia groups (51
 patients). Based on 28-day survival, bacteremia patients were also divided into survivor (22
 patients) and non-survivor groups (11 patients). Serum sTREM-1 and PCT levels were summarized
 as medians (interquartile ranges) and CRP levels were presented as means ± standard
 deviations. To explore the early diagnostic value of soluble triggering receptor expressed on
 myeloid cells 1 (sTREM-1), procalcitonin (PCT), and C-reactive protein (CRP) serum levels for
 identification of sepsis and bacteremia and the prognosis among patients with a fever of
 unknown origin (FUO) in the intensive care unit (ICU) and to discuss the clinical application
 of the results.
Inclusion Criteria:

 -  Male and female aged 18 years old and over;

 -  Clinically suspected infection;

 -  Fulfilled at least two criteria of systemic inflammatory response syndrome (a) core
 temperature higher than 38 °C or lower than 36 °C (b)respiratory rate above 20/min, or
 PCO2 below 32 mmHg (c) pulse rate above 90/min, and (d) white blood cell count greater
 than 12,000/μl or lower than < 4,000/μl or less than 10% of bands;

 -  Blood borne infections were diagnosed if the following criteria were met.(1) The blood
 culture tested positive at least for the same pathogen;(2) The patient had at least
 one of the following symptoms: fever, shivering, or low blood pressure and showed
 signs of at least one of the following conditions: the blood culture tested positive
 at least twice for common skin flora from different sites; the blood culture tested
 positive only once for the skin flora listed above, the intravascular catheter culture
 tested positive for the same pathogen and the correct antibiotic treatment had been
 initiated for the patient; or a positive serology test consistent with other clinical
 laboratory test results and unrelated to infections at different sites.

 Exclusion Criteria:

 Those who fulfilled one below:

 -  neutropenia (≤ 500 neutrophils/mm3)

 -  HIV infection, and

 -  patients or their relatives refused