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Boix-Palop L, Vergara A, Padilla E, Martínez D, Blanco A, Pérez J, Calbo E, Vila J, Casals-Pascual C. Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia. Microorganisms 2023; 11:1160. [PMID: 37317134 DOI: 10.3390/microorganisms11051160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/15/2023] [Accepted: 04/26/2023] [Indexed: 06/16/2023] Open
Abstract
The aim of this study was to evaluate the diagnostic performance of plasma Lipocalin-2 (LCN2) concentration in adult patients with community-acquired pneumonia (CAP) to determine its etiology, severity and prognosis. A prospective observational study involving adults with CAP from November 2015 to May 2017 was conducted. Plasma LCN2 concentration was measured upon admission by a modified enzyme immunoassay coupled with chemiluminescence (Architect, Abbott Laboratories). The diagnostic performance of LCN2, C-reactive protein (CRP) and white blood cell to predict bacterial CAP was assessed. A total of 130 patients with CAP were included: 71 (54.6%) bacterial CAP, 42 (32.3%) unknown origin CAP and 17 (13.1%) viral CAP. LCN2 was higher in bacterial CAP than in non-bacterial CAP (122.0 vs. 89.7 ng/mL, respectively) (p = 0.03) with a limited ability to distinguish bacterial and non-bacterial CAP (AUROC: 0.62 [95% CI 0.52-0.72]). The LCN2 cutoff ≥ 204 ng/mL predicted the presence of pneumococcal bacteremia with an AUROC of 0.74 (sensitivity 70%, specificity 79.1%). Regarding severity, as defined by CURB-65 and PSI scores, there was a significant linear trend in the mean concentration of LCN2, exhibiting a shift from the low-risk to the intermediate-risk and high-risk group (p < 0.001 and 0.001, respectively). LCN2 concentration was associated with severity in adult patients with CAP. However, its utility as a biomarker to discriminate viral and bacterial etiology in CAP is limited.
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Affiliation(s)
- Lucía Boix-Palop
- Infectious Diseases Department, Hospital Universitari Mútua de Terrassa, 08221 Terrassa, Spain
- School of Medicine, University of Barcelona, 08908 Barcelona, Spain
- School of Medicine, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
| | - Andrea Vergara
- School of Medicine, University of Barcelona, 08908 Barcelona, Spain
- Biomedical Diagnostic Center (CDB), Department of Clinical Microbiology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- Instituto de Salud Global (ISGlobal), 08036 Barcelona, Spain
| | - Emma Padilla
- Department of Clinical Microbiology, Catlab, 08232 Viladecavalls, Spain
| | - Diego Martínez
- Biomedical Diagnostic Center (CDB), Department of Clinical Microbiology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
| | - Ana Blanco
- Department of Clinical Microbiology, Catlab, 08232 Viladecavalls, Spain
| | - Josefa Pérez
- Department of Clinical Microbiology, Catlab, 08232 Viladecavalls, Spain
| | - Esther Calbo
- Infectious Diseases Department, Hospital Universitari Mútua de Terrassa, 08221 Terrassa, Spain
- School of Medicine, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
| | - Jordi Vila
- School of Medicine, University of Barcelona, 08908 Barcelona, Spain
- Biomedical Diagnostic Center (CDB), Department of Clinical Microbiology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- Instituto de Salud Global (ISGlobal), 08036 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), ISCIII, 28006 Madrid, Spain
| | - Climent Casals-Pascual
- School of Medicine, University of Barcelona, 08908 Barcelona, Spain
- Biomedical Diagnostic Center (CDB), Department of Clinical Microbiology, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- Instituto de Salud Global (ISGlobal), 08036 Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), ISCIII, 28006 Madrid, Spain
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