الفهرس 
Ventilator-Associated PneumoniaOnly 14 pages are availabe for public view
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Abstract
VAP, with frequencies of from 1.2 to 8.5 per 1000 ventilation days, is the second most frequently reported HAI in adult patients.
Diagnosis of VAP represent an significant problem for clinicians because of non-specific, standardized clinical standards for diagnosis, in relation to time-consuming outcomes of bacteriological culture, which may encourage physicians to initiate empirical antimicrobial therapy that may cost patients more harm and resistance, thus there is a need for rapid, accurate, and inexpensive diagnostic methods for VAP.
Biomarkers may help in improving accuracy and speed of VAP diagnosis.
PTX3 is a is an acute-phase mediator produced by many cell types at sites of infection and inflammation, in the lungs; leucocytes, endothelial cells and epithelial cells may produce PTX3 when stimulated, and it can be measured in few hours.
The aim of this study was to assess the role of PTX3 as a biomarker in diagnosis of VAP during the course of six months in the CICU of Ain Shams University hospitals.
Our study included two groups, the first included 30 patients with suspected VAP by modified CPIS, and the second included 30 healthy controls. For CPIS used for diagnosing VAP in patients the mean was 7.77 ± 1.74.
29 bacterial pathogens were isolated from 24 patients (80%), the most common isolated organism was staphylococcus aureus (8 cases 27.6%), followed by klebsiella pneumoniae (6 cases 20.7%), then Pseudomonas aeruginosa (4 cases 13.7%), then enterococcus faecalis(3 cases 10.3%), then Escherichia coli(3 cases 10.3%), after it Enterobacter cloacae(2 cases 6.9%), proteus mirabilis(2 cases 6.9%), and least one was Citrobacter (1 case 3.4%),and six patients (20%) were negative for bacteriological culture.
Many studies clarify that the accuracy of PTX3 levels in BAL fluid for diagnosing pneumonia might be superior to other current biomarkers with 96.7% sensitivity, 100% specificity.
MiniBal PTX3 cut-off point of >3.6 ng/ml; had sensitivity of 95.83% and a specificity of 100%,
For serum PTX3 a cut-off point of ≥7 ng/ml had sensitivity of 62.5% and a specificity of 100% and total accuracy was 70.0%.
A cut-off level of CRP levels ≥12 mg/dl in serum was associated with 62.5% sensitivity, 83.3% specificity for confirmed bacterial VAP and total accuracy 66.7%.