Gille Jochen, Jocovic Jovan, Kremer Thomas, Sablotzki Armin
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital gGmbH Leipzig Germany.
Department of Plastic and Hand Surgery with Burn Care Unit, St. Georg Hospital gGmbH Leipzig Germany.
Int J Burns Trauma. 2021 Apr 15;11(2):123-130. eCollection 2021.
Interleukin 6 (IL-6) is an established biomarker of inflammation with one of the earliest responses in sepsis. Serum levels can easily be measured within a few hours. The clinical significance of IL-6 in the early stage of sepsis in burned patients has not yet been confirmed. The purpose of our research was to investigate the predictive value of IL-6 for positive blood cultures in comparison to Procalcitonin (PCT), white blood cell (WBC) count, body temperature and the Sequential Organ Failure Assessment (SOFA) score in the presence of suspected sepsis in burn patients. In a retrospective study, we included all patients admitted to a regional burn centre in a 7-year period. Patients with a clinical suspicion of sepsis and complete laboratory tests underwent further analysis. Patients were categorized following culture results into either positive or negative bloodstream infection (BSI or non-BSI) groups. 39 of the 101 included patients had positive blood cultures (BSI). The serum IL-6 levels were significantly higher in the BSI group [1047 (339.9; 9000.5) vs. 198.5 (112.4; 702.5) ng/l; P = 0.001]. Receiver operating characteristic (ROC) curve analysis showed an AUC of 0.7 (59; 80.8%). The optimal IL-6 cut-off level was 312.8 ng/l (sensitivity 79.5%, specificity 56.5%). Other biomarkers (PCT, WBC), the maximum body temperature and increase of SOFA score were not different between the groups. IL-6 can be used to predict a positive blood culture even in the early stage of suspected sepsis in burned patients. In this context, other biomarkers (PCT, WBC) and body temperature are of limited clinical utility.
白细胞介素6（IL-6）是一种公认的炎症生物标志物，在脓毒症中反应最早。血清水平可在数小时内轻松测定。IL-6在烧伤患者脓毒症早期的临床意义尚未得到证实。我们研究的目的是在烧伤患者疑似脓毒症的情况下，将IL-6与降钙素原（PCT）、白细胞（WBC）计数、体温和序贯器官衰竭评估（SOFA）评分相比较，探讨其对血培养阳性的预测价值。在一项回顾性研究中，我们纳入了7年内入住某地区烧伤中心的所有患者。临床怀疑脓毒症且实验室检查完整的患者接受进一步分析。根据培养结果将患者分为血流感染阳性或阴性（BSI或非BSI）组。101例纳入患者中有39例血培养阳性（BSI）。BSI组的血清IL-6水平显著更高[1047（339.9；9000.5）对198.5（112.4；702.5）ng/l；P = 0.001]。受试者工作特征（ROC）曲线分析显示曲线下面积（AUC）为0.7（59；80.8%）。IL-6的最佳截断水平为312.8 ng/l（敏感性79.5%，特异性56.5%）。其他生物标志物（PCT、WBC）、最高体温和SOFA评分的增加在两组之间无差异。即使在烧伤患者疑似脓毒症的早期，IL-6也可用于预测血培养阳性。在此背景下，其他生物标志物（PCT、WBC）和体温的临床效用有限。
