A preliminary study of paraoxonase-1 in infected patients with an indwelling central venous catheter

Abstract

Objectives: Identification of biochemical markers to diagnose bloodstream infections in patients with a central venous catheter (CVC) inserted is an active research pursuit. Paraoxonase-1 (PON1) is an enzyme participating in the innate immune system protecting against toxic substances and infectious agents. We investigated the relationships between serum PON1 alterations and the characteristics of infection in a group of patients with a CVC implant.

Methods: Patients (n=114) who had had an inserted CVC removed because of infection or because the usefulness was at an end, and 407 healthy volunteers were recruited. In all participants we measured serum PON1 lactonase and paraoxonase activities, PON1 concentration and genetic polymorphisms, together with levels of the chemokine (C-C motif) ligand 2 (CCL2), procalcitonin and C-reactive protein (CRP).

Results: Patients with an acute concomitant infection (ACI) had higher CCL2, CRP and procalcitonin concentrations than the control group, together with lower paraoxonase and lactonase activities and specific activities. The areas under the curve of the receiver operating characteristic plots for paraoxonase and lactonase specific activities in the discrimination between patients with or without and ACI were 0.81 (0.73-0.89) and 0.81 (0.71-0.89), respectively, indicating the high diagnostic accuracy of these parameters.

Conclusion: This preliminary study suggests that the measurement of PON1 may be useful as a tool for the diagnosis of ACI in patients with an indwelling CVC.

Keywords: Biomarkers; Catheters; Infection; Paraoxonase-1.