C-reactive protein and procalcitonin concentrations in bronchoalveolar lavage fluid as a predictor of ventilator-associated pneumonia

Ann Clin Biochem 2008;45:293-298
© 2008 Association for Clinical Biochemistry


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Original Articles

Catharina F M Linssen1,
Otto Bekers2,
Marjolein Drent3 and
Jan A Jacobs1

1 Department of Medical Microbiology;
2 Department of Clinical Chemistry;
3 Department of Respiratory Medicine, University Hospital Maastricht, P Debyelaan 25, 6202 AZ Maastricht, The Netherlands

Corresponding author: Dr Catharina F M Linssen. Email: klin{at}lmib.azm.nl

Background: Diagnosis of ventilator-associated pneumonia (VAP) is difficult.The usefulness of high-sensitivity procalcitonin (ProCa-S) andhigh-sensitivity C-reactive protein (CRPH) in bronchoalveolarlavage (BAL) fluid and serum in the prediction of VAP was determined.

Methods: The study was conducted over a 28-month period (November 1999–June2002) at the University Hospital Maastricht. BAL fluid sampleswere collected from patients admitted to the intensive careunit. Differential cell count and quantitative culture of BALfluid were performed. C-reactive protein (CRP) and procalcitonin(PCT) on BAL fluid were determined by means of two high-sensitivitykits (CRPH and ProCa-S, respectively). Since both kits weredesigned for use on serum, validation for use on BAL fluid wasperformed.

Results: A total of 117 patients were included. 43.6% (51/117) had microbiologicallyconfirmed VAP. Both CRPH and ProCa-S showed good matrix effect,linearity and intra- and inter-assay variation. No significantdifferences in PCT and CRP concentrations in serum and BAL fluidwere found between the VAP and the non-VAP group.

Conclusions: Both the ProCa-S and the CRPH kits can be used for assessingthe concentration of PCT and CRP in BAL fluid, respectively.PCT and CRP concentrations in BAL fluid appeared to be of noadditional value in the diagnosis of VAP.

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