Biomarkers in HIV-infected patients with community-acquired pneumonia
| Based on composite diagnostic standard* | Based on expanded composite diagnostic standard† | |||||
|---|---|---|---|---|---|---|
| Pneumococcal aetiology* | Non-pneumococcal aetiology* | p Value* | Pneumococcal aetiology† | Non-pneumococcal aetiology† | p Value† | |
| Procalcitonin (ng/mL) | 18.8 (n=84) | 6.93 (n=153) | <0.0001 | 16.2 (n=128) | 5.1 (n=109) | <0.0001 |
| Proadrenomedullin (MR-proADM; nmol/L) | 2.9 (n=80) | 1.9 (n=156) | 0.01 | 2.8 (n=125) | 1.6 (n=111) | 0.003 |
| Proatrial natriuretic peptide (MR-proANP; pmol/L) | 119.4 (n=81) | 120.9 (n=156) | 0.93 | 118.7 (n=126) | 122.3 (n=111) | 0.84 |
| Copeptin (pmol/L) | 73.0 (n=82) | 46.2 (n=155) | 0.07 | 68.6 (n=127) | 40.3 (n=110) | 0.0476 |
| CRP (mg/L) | 282.9 (n=20) | 134.4 (n=27) | <0.0001 | 248.2 (n=27) | 129.3 (n=20) | 0.0009 |
Since C reactive protein (CRP) values were available only when requested by the treating physicians, we compared patients with available values for CRP to patients without available CRP values. There was no difference in mean age, in mean nasopharyngeal colonisation density and no difference in pneumococcal diagnosis. However, patients with an available CRP value had a significantly higher (30.6%) in-hospital mortality compared to patients without a CRP value (15.3%) (p=0.02).
*Pneumococcal and non-pneumococcal aetiology were defined according to composite diagnostic standard (pneumococci were detected by either blood culture, urine immunochromatographic BinaxNow Streptococcus pneumoniae test, good quality (ie, >25 neutrophils and <10 epithelial cells per high-power field) sputum Gram stain or culture, or whole blood lytA rtPCR). (rt, real-time).
†Pneumococcal and non-pneumococcal aetiology were defined according to composite diagnostic standard (pneumococci were detected by either blood culture, urine immunochromatographic BinaxNow Streptococcus pneumoniae test, good quality (ie, >25 neutrophils and <10 epithelial cells per high-power field) sputum Gram stain or culture, or whole blood lytA rtPCR or lytA rtPCR from nasal swab >8000 copies/mL).