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    Diagnostic role of opsonic activity in Acinetobacter baumannii ventilator-associated pneumonia
    (Elsevier, 2024) Karakullukçu, Asiye; Akker, Mustafa; Kuşkucu, Mert Ahmet; Dikmen, Yalım; Aygün, Gökhan
    In this study, we investigated the diagnostic value of opsonic activity against Acinetobacter baumannii in Ventilator-Associated Pneumonia (VAP) among 50 patients, compared to 102 negative and positive controls. Out of the 50 patients, only 33 (66 %) were diagnosed with VAP using the Clinical Pulmonary Infection Score (CPIS). The opsonic activity assay demonstrated three key findings: (i) 95 % sensitivity and 91.7 % specificity, with a Receiver Operating Characteristic (ROC) area of 0.976 for distinguishing A. baumannii culture positives from negatives; (ii) 95 % sensitivity and 78.7 % specificity, with a 0.915 ROC area, in differentiating VAP/blood culture positive patients from colonized/negative groups; (iii) An ROC area of 0.553 for VAP and colonization, as identified by CPIS alone, indicating an indeterminate threshold. These results highlight that CPIS, microbiological, and clinical evaluations were not correlated, suggesting that opsonic activity against A. baumannii could be a potential VAP diagnostic tool, with the need for large-scale validations.
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    Evaluating a pathogen-specific IgG binding assay for rapid detection of healthcare-associated infections
    (Nature Portfolio, 2026) Karakullukçu, Asiye; Akker, Mustafa; Kuşkucu, Mert Ahmet; Aygün, Gökhan; Dikmen, Yalım
    Rapid and accurate diagnosis of healthcare-associated infections (HAIs) is an unmet need for improving outcomes in intensive care units (ICUs). Traditional culture-based methods, while the gold standard, are time-consuming and can delay therapeutic interventions. In this study, we evaluated the diagnostic utility of pathogen-specific immunoglobulin G (IgG) binding levels using an enzyme-linked immunosorbent assay (ELISA). We measured IgG binding against pathogens including Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, and Staphylococcus aureus. Diagnostic performance was evaluated through receiver operating characteristic (ROC) curve analysis, with culture results as the reference. The assay demonstrated an overall diagnostic accuracy of 83.2%, with a sensitivity of 85.4%, a specificity of 81.4%, and an area under the curve (AUC) of 0.910. Pathogen-specific cutoff values ranged from 0.918 to 1.534. Especially, A. baumannii showed the highest performance metrics, achieving a sensitivity of 94.7%, a specificity of 93.6%, and an AUC of 0.975. The pathogen-specific IgG binding levels can offer a novel and effective diagnostic tool for the initial assessment of HAIs, enhancing early detection and improving patient management across healthcare settings.