TY - JOUR
T1 - Plasma cytokine profile on admission related to aetiology in Community Acquired Pneumonia
AU - Burgmeijer, Eduard H
AU - Duijkers, Ruud
AU - Lutter, René
AU - Bonten, Marc J M
AU - Schweitzer, Valentijn A
AU - Boersma, Wim G
N1 - Funding Information:
The authors thank Mrs B. Dierdorp and T. Dekker (Amsterdam UMC, University of Amsterdam) for performing the assays and helping with the interpretation of results. The authors thank Mr T. van der Ploeg for statistical assistance. None of the authors have conflicting interests.
Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2019/10
Y1 - 2019/10
N2 - Background: Potentially unnecessary antibiotic use for community-acquired pneumonia (CAP) contributes to selection of antibiotic-resistant pathogens. Cytokine expression at the time that treatment is started may assist in identifying patients not requiring antibiotics. We determined plasma cytokine patterns in patients retrospectively categorized as strict viral, pneumococcal or combined viral-bacterial CAP. Objective: To investigate whether cytokine-based prediction models can be used to differentiate strict viral CAP from other aetiologies at admission. Methods: From 344 hospitalized CAP patients, 104 patients were categorized as viral CAP (n = 17), pneumococcal CAP (n = 48) and combined bacterial-viral CAP (n = 39). IL-6, IL-10, IL-27, IFN-γ and C-reactive protein (CRP) were determined on admission in plasma. Prediction of strict viral aetiology was explored with two multivariate regression models and ROC curves. Results: Viral pneumonia was predicted by logistic regression using multiple cytokine levels (IL-6, IL-27 and CRP) with an AUC of 0.911 (95% CI: 0.852-0.971, P <.001). For the same patients the AUC of CRP was 0.813 (95% CI: 0.728-0.898, P <.001). Conclusions: This study demonstrated differences in cytokine expression in selected CAP patients between viral and bacterial aetiology. Prospective validation studies are warranted.
AB - Background: Potentially unnecessary antibiotic use for community-acquired pneumonia (CAP) contributes to selection of antibiotic-resistant pathogens. Cytokine expression at the time that treatment is started may assist in identifying patients not requiring antibiotics. We determined plasma cytokine patterns in patients retrospectively categorized as strict viral, pneumococcal or combined viral-bacterial CAP. Objective: To investigate whether cytokine-based prediction models can be used to differentiate strict viral CAP from other aetiologies at admission. Methods: From 344 hospitalized CAP patients, 104 patients were categorized as viral CAP (n = 17), pneumococcal CAP (n = 48) and combined bacterial-viral CAP (n = 39). IL-6, IL-10, IL-27, IFN-γ and C-reactive protein (CRP) were determined on admission in plasma. Prediction of strict viral aetiology was explored with two multivariate regression models and ROC curves. Results: Viral pneumonia was predicted by logistic regression using multiple cytokine levels (IL-6, IL-27 and CRP) with an AUC of 0.911 (95% CI: 0.852-0.971, P <.001). For the same patients the AUC of CRP was 0.813 (95% CI: 0.728-0.898, P <.001). Conclusions: This study demonstrated differences in cytokine expression in selected CAP patients between viral and bacterial aetiology. Prospective validation studies are warranted.
KW - cytokines
KW - immunology
KW - pneumonia
KW - viral infection
UR - http://www.scopus.com/inward/record.url?scp=85070757259&partnerID=8YFLogxK
U2 - 10.1111/crj.13062
DO - 10.1111/crj.13062
M3 - Article
C2 - 31310442
SN - 1752-6981
VL - 13
SP - 605
EP - 613
JO - The clinical respiratory journal
JF - The clinical respiratory journal
IS - 10
ER -