Medizinische Universität Graz - Research portal
Selected Publication:
Reichsöllner, M.
Clinical evaluation of automated multiplexed combined inflammation biomarker tests for prognosis and diagnosis in patients with systemic inflammatory response syndrome
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 79
[OPEN ACCESS]
FullText
- Authors Med Uni Graz:
- Advisor:
- Hönigl Martin
- Raggam Reinhard Bernd
- Altmetrics:
- Abstract:
- Background: Sepsis, defined as systemic inflammatory response syndrome (SIRS) due to infection is associated with substantial morbidity and mortality. Early diagnosis for an appropriate treatment proves to be vital in the quest to ameliorate its prognosis. While so far no biomarker was able to substitute time-consuming blood cultures, some are used for additional assessment. In this study we investigated the potential of established as well as new biomarkers regarding diagnosis and prognosis of bacteremia/fungemia in patients with SIRS. Methods: 159 patients presenting with SIRS at the emergency department (blood cultures: 49 negative, 49 Staphylococcus aureus, 51 Escherichia Coli, 10 Candida spp.), 27 of whom died within 30 days after admission, were included in this study. Apart from the routinely tested CRP, PCT, suPAR, IL-6 and creatinine, frozen plasma from the patient population was used to determine levels of IL-8, SAA, cystatin C, NGAL, IL-10, fibronectin, thrombomodulin, biotin and substance P with the help of Anagnostics’ inflammation-monitoring (competitive- and sandwich-immunoassays; Anagnostics Bioanalysis GmbH). The data was analysed statistically including receiver operating characteristics (ROC) curve analysis. Results: PCT (p=0,001), suPAR (p=0,001), Biotin (p=0,004), IL-8 (p=0,009) and NGAL (p=0,046) were elevated significantly in patients with bacteremia/fungemia, while fibronectin levels were diminished (p=0,020). The highest area under the curve (AUC) value in the prognosis of bacteremia/fungemia exhibited PCT with 0,694 (sensitivity 62% and specificity 67% for a cut-off at 0,6 ng/mL), followed by suPAR (0,660), Biotin (0,646) and IL-8 (0,625). The best performance in the prognosis of 30-days mortality was accomplished by suPAR (AUC 0,676), Biotin (AUC 0,663), IL-8 (AUC 0,637) and PCT (AUC 0,630). Conclusion: PCT, suPAR, biotin and IL-8 were the most promising biomarkers for the prediction of positive blood cultures as well as 30-days mortality in patients with SIRS. Overall, however, none of the investigated biomarkers appeared as reliable predictor of bacteremia/fungemia in patients from the emergency department presenting with SIRS.