Lee Beomki, Park Jong Eun, Yoon Sun Joo, Park Chi-Min, Lee Nam Yong, Shin Tae Gun, Kang Eun-Suk
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Infect Chemother. 2024 Mar;56(1):47-56. doi: 10.3947/ic.2023.0066. Epub 2023 Nov 21.
CD14 recognizes lipopolysaccharide (LPS), and presepsin is a fragment of soluble CD14. Still, it remains uncertain whether Gram-negative bacteria induce higher presepsin levels than other microorganisms. To address this question, this study aimed to analyze presepsin levels based on microorganisms isolated in blood cultures.
This study was a single-center study comprising suspected sepsis patients enrolled from July 2020 to September 2020. A total of 95 patients with a single isolate confirmed in blood culture were analyzed to evaluate if there are any differences in presepsin levels according to microbial isolates. Plasma presepsin level was measured using PATHFAST assay kit and analyzer (LSI Medience Corporation, Tokyo, Japan).
There were 26 Gram-positive bacteremia, 65 Gram-negative bacteremia, and 3 fungemia patients with median presepsin levels of 869, 1,439, and 11,951 pg/mL, respectively. Besides, one case of algaemia demonstrated a presepsin level of 1,231 pg/mL. Our results showed no statistically significant difference in presepsin levels among patients with Gram-positive bacteremia, Gram-negative bacteremia, and fungemia. Furthermore, presepsin levels did not differ significantly among bloodstream infections caused by bacteria that were isolated from at least three different patients. In particular, Gram-positive bacteria such as and were able to induce presepsin levels comparable to those induced by Gram-negative bacteria.
We demonstrated that there were no significant differences in plasma presepsin levels according to microbial isolates in blood culture. The major cause of the variability in presepsin levels during bloodstream infection might be the immunogenicity of each microorganism rather than the presence of LPS in the microorganism.
CD14可识别脂多糖（LPS），而可溶性预激肽原是可溶性CD14的一个片段。然而，革兰氏阴性菌是否比其他微生物诱导更高的预激肽原水平仍不确定。为解决这个问题，本研究旨在根据血培养中分离出的微生物分析预激肽原水平。
本研究为单中心研究，纳入了2020年7月至2020年9月疑似脓毒症患者。对95例血培养中确诊为单一菌株感染的患者进行分析，以评估根据微生物分离株的预激肽原水平是否存在差异。使用PATHFAST检测试剂盒和分析仪（日本东京LSI Medience公司）测量血浆预激肽原水平。
有26例革兰氏阳性菌血症、65例革兰氏阴性菌血症和3例真菌血症患者，其预激肽原水平中位数分别为869、1439和11951 pg/mL。此外，1例藻类血症患者的预激肽原水平为1231 pg/mL。我们的结果显示，革兰氏阳性菌血症、革兰氏阴性菌血症和真菌血症患者的预激肽原水平在统计学上无显著差异。此外，由至少三名不同患者分离出的细菌引起的血流感染中，预激肽原水平也无显著差异。特别是，某些革兰氏阳性菌能够诱导与革兰氏阴性菌相当的预激肽原水平。
我们证明，根据血培养中的微生物分离株，血浆预激肽原水平无显著差异。血流感染期间预激肽原水平变化的主要原因可能是每种微生物的免疫原性，而非微生物中LPS的存在。
