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Marin H. Kollef, MD; Nitin Anand, MD; Scott Zuick, MD; Julia Klesney-Tait, MD
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Affiliations: Washington University School of Medicine St. Louis, MO,  University of Iowa Hospitals and Clinic Iowa City, IA

Correspondence to: Marin H. Kollef, MD, Department of Pulmonary and Critical Care, Washington University School of Medicine, 660 S Euclid Ave, Box 8052, St. Louis, MO 63110-1093; e-mail: mkollef@im.wustl.edu


Dr. Kollef's effort was supported by the Barnes-Jewish Hospital Foundation. Drs. Anand, Zuick, and Klesney-Tait have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(1):320. doi:10.1378/chest.09-0755
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To the Editor:

We appreciate Dr. Gibot's comments. The assay we employed was commercially available at the time we conducted our study.1 The studies of soluble triggering receptor expressed on myeloid cells-1 (or STREM-1) as a diagnostic marker of infection highlight the problems with using assays that are often expensive and nonreproducible in place of other methods (eg, quantitative cultures of the lower respiratory tract) to diagnose infections like ventilator-associated pneumonia. These problems include variances in the available assays and their components (eg, antibodies, reagents), and the lack of validation of such assays under clinically relevant conditions. Given the fact that only commercially available assays would be used clinically in the future, we suggest that any new assay be validated against proven clinical methods prior to being accepted as a standard for the diagnosis of ventilator-associated pneumonia.

Anand NJ, Zuick S, Klesney-Tait J, et al. Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU. Chest. 2009;135:641-647. [PubMed] [CrossRef]
 

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Anand NJ, Zuick S, Klesney-Tait J, et al. Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU. Chest. 2009;135:641-647. [PubMed] [CrossRef]
 
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