Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients  

作　　者：Tao Wang Yun-Liang Cui Zhao-Fen Lin De-Chang Chen 

机构地区：[1]Department of Emergency and Intensive Care Unit, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572013, China [2]Department of Critical Care Medicine, Jinan Military General Hospital, Jinan, Shandong 250031, China [3]Department of Emergency Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

出　　处：《Chinese Medical Journal》2016年第4期417-423,共7页中华医学杂志（英文版）

基　　金：This study was partly supported by grants from the National Natural Science Foundation of China，Shanghai Health System Advanced Suitable Technology Popularization Project，Natural Science Foundation of Shandong Province

摘　　要：Background： Both procalcitonin （PCT） and plasma endotoxin levels cannot be solely used for a definite diagnosis ofbacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia.The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis ofbacteremia in Intensive Care Unit （ICU）.Methods： The medical records of 420 patients in ICU were retrospectively reviewed.Patients （n =241） who met the inclusion criteria were subjected to blood culture （BC） for the analysis of the endotoxin or PCT levels.The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors.Patients＆#39; BC episodes were divided into BC negative, Gram-negative （GN） bacteria, Gram-positive bacteria, and fungi groups.The PCT and plasma endotoxin levels were compared in the different groups.Results： A total of 241 patients with 505 episodes of BC were analyzed.The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups.GN bacteremia was more prevalent than Gram-positive bacteremia.The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.The plasma endotoxin significantly differed among different groups and was bacterial species dependent.Conclusions： Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia.Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China.And PCT is a more valuable biomarker than endotoxin in the diagnosBackground： Both procalcitonin （PCT） and plasma endotoxin levels cannot be solely used for a definite diagnosis ofbacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia.The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis ofbacteremia in Intensive Care Unit （ICU）.Methods： The medical records of 420 patients in ICU were retrospectively reviewed.Patients （n =241） who met the inclusion criteria were subjected to blood culture （BC） for the analysis of the endotoxin or PCT levels.The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors.Patients＆#39; BC episodes were divided into BC negative, Gram-negative （GN） bacteria, Gram-positive bacteria, and fungi groups.The PCT and plasma endotoxin levels were compared in the different groups.Results： A total of 241 patients with 505 episodes of BC were analyzed.The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups.GN bacteremia was more prevalent than Gram-positive bacteremia.The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups.The plasma endotoxin significantly differed among different groups and was bacterial species dependent.Conclusions： Plasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia.Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China.And PCT is a more valuable biomarker than endotoxin in the diagnos

关 键 词：BACTEREMIA ENDOTOXIN Intensive Care Unit PROCALCITONIN SEPSIS 

分 类 号：Q516[生物学—生物化学] TQ460.6[化学工程—制药化工]