Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia
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 M...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/11/5/1160 |
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| author | Lucía Boix-Palop Andrea Vergara Emma Padilla Diego Martínez Ana Blanco Josefa Pérez Esther Calbo Jordi Vila Climent Casals-Pascual |
| author_facet | Lucía Boix-Palop Andrea Vergara Emma Padilla Diego Martínez Ana Blanco Josefa Pérez Esther Calbo Jordi Vila Climent Casals-Pascual |
| author_sort | Lucía Boix-Palop |
| collection | DOAJ |
| description | 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) (<i>p</i> = 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 (<i>p</i> < 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. |
| first_indexed | 2024-03-11T03:28:22Z |
| format | Article |
| id | doaj.art-64b2f194649648d5bf80ff3e38801d4a |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T03:28:22Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-64b2f194649648d5bf80ff3e38801d4a2023-11-18T02:32:41ZengMDPI AGMicroorganisms2076-26072023-04-01115116010.3390/microorganisms11051160Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired PneumoniaLucía Boix-Palop0Andrea Vergara1Emma Padilla2Diego Martínez3Ana Blanco4Josefa Pérez5Esther Calbo6Jordi Vila7Climent Casals-Pascual8Infectious Diseases Department, Hospital Universitari Mútua de Terrassa, 08221 Terrassa, SpainSchool of Medicine, University of Barcelona, 08908 Barcelona, SpainDepartment of Clinical Microbiology, Catlab, 08232 Viladecavalls, SpainBiomedical Diagnostic Center (CDB), Department of Clinical Microbiology, Hospital Clinic of Barcelona, 08036 Barcelona, SpainDepartment of Clinical Microbiology, Catlab, 08232 Viladecavalls, SpainDepartment of Clinical Microbiology, Catlab, 08232 Viladecavalls, SpainInfectious Diseases Department, Hospital Universitari Mútua de Terrassa, 08221 Terrassa, SpainSchool of Medicine, University of Barcelona, 08908 Barcelona, SpainSchool of Medicine, University of Barcelona, 08908 Barcelona, SpainThe 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) (<i>p</i> = 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 (<i>p</i> < 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.https://www.mdpi.com/2076-2607/11/5/1160lipocalin-2community-acquired pneumoniaseveritybiomarkerpneumococcal pneumonia |
| spellingShingle | Lucía Boix-Palop Andrea Vergara Emma Padilla Diego Martínez Ana Blanco Josefa Pérez Esther Calbo Jordi Vila Climent Casals-Pascual Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia Microorganisms lipocalin-2 community-acquired pneumonia severity biomarker pneumococcal pneumonia |
| title | Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia |
| title_full | Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia |
| title_fullStr | Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia |
| title_full_unstemmed | Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia |
| title_short | Evaluation of Plasma Lipocalin-2 as a Predictor of Etiology and Severity in Adult Patients with Community-Acquired Pneumonia |
| title_sort | evaluation of plasma lipocalin 2 as a predictor of etiology and severity in adult patients with community acquired pneumonia |
| topic | lipocalin-2 community-acquired pneumonia severity biomarker pneumococcal pneumonia |
| url | https://www.mdpi.com/2076-2607/11/5/1160 |
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