The clinical utility of pentraxin 3 for the early diagnosis of infection in mechanically ventilated patients

Abstract

Background Ventilator-associated pneumonia (VAP) is one of the most common ICU-acquired infections; however, its diagnosis is still a challenge. Objectives To evaluate the diagnostic performance of pentraxin 3 (PTX3) in early detection of patients with VAP. Patients and methods In the period from the first of January 2019 up to December 2021, 45 adult patients who underwent mechanical ventilation more than 48 h and developed VAP were enrolled in this longitudinal descriptive hospital-based study, Assiut University Hospital, Assiut, Egypt. Diagnosis of VAP depends on positive culture, in addition to a clinical pulmonary infection score more than or equal to 7. To measure the level of PTX3, the first sample was taken on the first day of the endotracheal intubation, and the second sample was taken on the third day from the patients who developed VAP. Results The study showed that the mean age of enrolled patients was 55.98 ± 14.54 years (range, 30–80 years). Overall, 60% were males and 40% were females. The most common causative pathogen was Pseudomonas aeruginosa, followed by Staphylococcus aureus. Only PTX3 showed significant increase during follow-up, whereas no significant difference was observed in either erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) during the follow-up period. Moreover, it was observed that PTX3 had a significant positive correlation with CRP; however, it did not show correlation with ESR, whereas CRP had a significant positive correlation with ESR. Conclusions PTX3 was superior to both ESR and CRP as a biomarker to diagnose patients with VAP and also for follow-up of disease progression.