Khana Thikra Qader, Anwar Khanda Abdulateef
Microbiology Department, Shar Teaching Hospital, Sulaimaniyah Directorate of Health, Sulaimaniyah, Iraq.
Microbiology Department, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq.
Int J Gen Med. 2023 Aug 31;16:3963-3976. doi: 10.2147/IJGM.S415200. eCollection 2023.
Sepsis is a highly mixed ailment that affects patients with numerous conditions of infectious sources and can lead to multi-organ failure with dysregulated host immune response.
To determine inflammatory biomarkers in patients with sepsis caused by Gram-negative bacteria and compare their role in the early detection of sepsis.
This cross-sectional study was conducted on patients with sepsis admitted to the intensive care unit at different hospitals in Sulaimaniyah, Iraq, from May to December 2021. Patients (n=147) were enrolled in this study according to the primary diagnosis of sepsis by Sequential Organ Failure Assessment scores. Blood samples were taken from patients to investigate white blood cells, inflammatory biomarkers (pentraxin-3, procalcitonin, adrenomedullin, lipopolysaccharide binding protein, interleukin-17A, lactate dehydrogenase, and C-creative protein), blood culture, antibiotic susceptibility test, and coagulation biomarkers (Prothrombin time, activated partial thromboplastin time, and international normalized ratio). Then, isolated Gram-negative bacteria were tested for extended-spectrum β-lactamase enzymes production by screening and combined disc tests.
A total of 51.7% samples were blood culture positive for different Gram-negative bacteria, and (51.95%) was a more isolated bacterium. Both males and females were affected by sepsis in a ratio of 1.23:1 with different age groups. Extended-spectrum β-lactamase was estimated to be 77.2% by antibiotic profile, and the rate decreased using two double-disc synergy tests. This was confirmed by combined disc test at a rate of 41.35%. The most prevalent biomarkers were procalcitonin (88.16%), adrenomedullin (84.21%), pentraxin-3 (22.37%), and lipopolysaccharide binding protein (11.84%).
Sepsis is a life-threatening condition that can be diagnosed early by several blood biomarkers such as procalcitonin, adrenomedullin, and pentraxin-3 combined with a standard blood culture technique to improve the patient outcome.
脓毒症是一种高度复杂的病症，影响患有多种感染源疾病的患者，并可导致宿主免疫反应失调的多器官功能衰竭。
确定革兰氏阴性菌引起的脓毒症患者的炎症生物标志物，并比较它们在脓毒症早期检测中的作用。
这项横断面研究于2021年5月至12月在伊拉克苏莱曼尼亚不同医院的重症监护病房收治的脓毒症患者中进行。根据序贯器官衰竭评估评分对脓毒症的初步诊断，纳入患者（n = 147）。采集患者血液样本以检测白细胞、炎症生物标志物（五聚素-3、降钙素原、肾上腺髓质素、脂多糖结合蛋白、白细胞介素-17A、乳酸脱氢酶和C反应蛋白）、血培养、抗生素敏感性试验和凝血生物标志物（凝血酶原时间、活化部分凝血活酶时间和国际标准化比值）。然后，通过筛选和联合纸片试验检测分离出的革兰氏阴性菌是否产生超广谱β-内酰胺酶。
共有51.7%的样本血培养出不同的革兰氏阴性菌呈阳性，其中（51.95%）是分离较多的细菌。不同年龄组的男性和女性受脓毒症影响的比例为1.23:1。根据抗生素谱估计超广谱β-内酰胺酶为77.2%，使用两种双纸片协同试验该比例降低。联合纸片试验以41.35%的比例证实了这一点。最常见的生物标志物是降钙素原（88.16%）、肾上腺髓质素（84.21%）、五聚素-3（22.37%）和脂多糖结合蛋白（11.84%）。
脓毒症是一种危及生命的病症，可通过降钙素原、肾上腺髓质素和五聚素-3等多种血液生物标志物结合标准血培养技术进行早期诊断，以改善患者预后。
