High plasma level of long pentraxin 3 (PTX3) is associated with fatal disease in bacteremic patients: a prospective cohort study.

Abstract

IntroductionLong pentraxin 3 (PTX3) is an acute-phase protein secreted by various cells, including leukocytes and endothelial cells. Like C-reactive protein (CRP), it belongs to the pentraxin superfamily. Recent studies indicate that high levels of PTX3 may be associated with mortality in sepsis. The prognostic value of plasma PTX3 in bacteremic patients is unknown.MethodsPlasma PTX3 levels were measured in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic streptococcae and Escherichia coli, using a commercial solid-phase enzyme-linked immunosorbent assay (ELISA). Values were measured on days 1-4 after positive blood culture, on day 13-18 and on recovery.ResultsThe maximum PTX3 values on days 1-4 were markedly higher in nonsurvivors compared to survivors (44.8 vs 6.4 ng/ml, p15 ng/ml) was associated with hypotension (MAP 15 ng/ml) remained an independent risk factor for case fatality in a logistic regression model adjusted for potential confounders.ConclusionsPTX3 proved to be a specific independent prognostic biomarker in bacteremia. PTX3 during the first days after diagnosis showed better prognostic value as compared to CRP, a widely used biomarker in clinical settings. PTX3 measurement offers a novel opportunity for the prognostic stratification of bacteremia patients.