Sébastien Gibot, MD; Marie-Nathalie Kolopp-Sarda, PharmD, PhD; Marie C. Béné, PharmSci, PhD; Aurélie Cravoisy, MD; Bruno Levy, MD, PhD; Gilbert C. Faure, MD, PhD; Pierre-Edouard Bollaert, MD, PhD
Acknowledgments: The authors thank Dr. Marco Colonna for providing anti–TREM-1 antibody and the nursing staff of the intensive care unit for their compliance with the study protocol.
Grant Support: By the Programme Hospitalier de Recherche Clinique, 2000–2003, and by the French Ministère de la Recherche et de la Technologie (grant EA3443).
Potential Financial Conflicts of Interest:Grants received: S. Gibot, M.-N. Kolopp-Sarda, M.C. Béné, G.C. Faure (Programme Hospitalier de Recherche Clinique, French Ministère de la Recherche et de la Technologie).
Requests for Single Reprints: Sébastien Gibot, MD, Hôpital Central, Service de Réanimation Médicale, 29 Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex, France.
Current Author Addresses: Drs. Gibot, Cravoisy, Lévy, and Bollaert: Hôpital Central, Service de Réanimation Médicale, 29 Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex, France.
Drs. Kolopp-Sarda, Béné, and Faure: Laboratoire d'Immunologie, Faculté de Médecine, Avenue du Foret de Haye, 54500 Vandoeuvre-les-Nancy, France.
Author Contributions: Conception and design: S. Gibot, M.-N. Kolopp-Sarda, B. Levy, P.-E. Bollaert.
Analysis and interpretation of the data: S. Gibot, M.-N. Kolopp-Sarda, M.C. Béné, A. Cravoisy, B. Levy, P.-E. Bollaert.
Drafting of the article: S. Gibot, M.C. Béné, P.-E. Bollaert.
Critical revision of the article for important intellectual content: M.C. Béné, A. Cravoisy, B. Levy, G.C. Faure, P.-E. Bollaert.
Final approval of the article: S. Gibot, M.-N. Kolopp-Sarda, M.C. Béné, A. Cravoisy, B. Levy, G.C. Faure, P.-E. Bollaert.
Provision of study materials or patients: S. Gibot, A. Cravoisy, B. Levy.
Statistical expertise: S. Gibot, M.-N. Kolopp-Sarda, M.C. Béné, B. Levy, G.C. Faure.
Obtaining of funding: M.-N. Kolopp-Sarda, M.C. Béné, G.C. Faure.
Administrative, technical, or logistic support: M.-N. Kolopp-Sarda, A. Cravoisy, G.C. Faure.
Collection and assembly of data: S. Gibot, B. Levy.
Previous experimental studies have suggested that the triggering receptor expressed on myeloid cells-1 (TREM-1) is specifically upregulated in the presence of microbial products.
To evaluate the diagnostic value of plasma levels of the soluble form of TREM-1 in patients admitted with clinical suspicion of infection.
Prospective, noninterventional study conducted between July and September 2003.
Medical adult intensive care unit at a university hospital in France.
76 consecutive newly admitted patients who presented with clinically suspected infection and fulfilled at least 2 criteria of the systemic inflammatory response syndrome.
Sensitivity and specificity of plasma soluble TREM-1 levels at admission for the diagnosis of infection. Two independent intensivists blinded to the results of soluble TREM-1 assays retrospectively classified patients as having the systemic inflammatory response syndrome, sepsis, severe sepsis, or septic shock.
The systemic inflammatory response syndrome was diagnosed in 29 patients (38%), and sepsis, severe sepsis, or septic shock was diagnosed in the remaining 47 (62%). A plasma soluble TREM-1 level higher than 60 ng/mL was more accurate than any other clinical or laboratory finding for indicating infection (sensitivity, 96% [95% CI, 92% to 100%]; specificity, 89% [CI, 82% to 95%]; positive likelihood ratio, 8.6 [CI, 3.8 to 21.5]; negative likelihood ratio, 0.04 [CI, 0.01 to 0.2]).
The study did not enroll patients with mild infections not requiring intensive care unit hospitalization, patients older than 80 years of age, or patients who were immunocompromised.
In newly admitted critically ill patients, measurement of plasma levels of soluble TREM-1 could help to rapidly identify those with infection.
Sébastien Gibot, Marie-Nathalie Kolopp-Sarda, Marie C. Béné, Aurélie Cravoisy, Bruno Levy, Gilbert C. Faure, et al. Plasma Level of a Triggering Receptor Expressed on Myeloid Cells-1: Its Diagnostic Accuracy in Patients with Suspected Sepsis. Ann Intern Med. 2004;141:9–15. doi: 10.7326/0003-4819-141-1-200407060-00009
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Published: Ann Intern Med. 2004;141(1):9-15.
Multi-Organ Failure and Sepsis, Pulmonary/Critical Care.
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