Borra Suma D, Morkar Dnyanesh N
Internal Medicine, Jawaharlal Nehru Medical College and Hospital, Belagavi, IND.
Cureus. 2023 Dec 21;15(12):e50890. doi: 10.7759/cureus.50890. eCollection 2023 Dec.
Sepsis is a complicated host response to infection involving organ failure which ultimately causes death of the host. Procalcitonin (PCT) is an effective marker used to diagnose sepsis but until now, there has been no ideal marker for sepsis. Phospholipase A2 (PLA2) also increases infections; however, only a few studies have assessed its capacity as a biomarker to diagnose sepsis. Thus, we aimed to examine PLA2 and compare its diagnostic capacity and accuracy with PCT as a biomarker of sepsis.
Our study was a hospital-oriented cross-sectional study. Our study group included 80 patients of both sexes older than 18 years, meeting the quick sequential organ failure assessment (qSOFA) or systemic inflammatory response syndrome (SIRS) criteria of ≥2, hospitalized in a tertiary care hospital in Karnataka, India from January 2021 to December 2021. Out of them, 59 were found to have sepsis. Samples of all the patients were evaluated for relevant parameters, and data were statistically analyzed using SPSS v21 running on Windows 10. The statistical significance was set at p-value <0.05.
The mean PCT and PLA2 were significantly raised in sepsis patients compared to non-sepsis patients. Out of 59 septic patients, 45.76% had positive blood cultures, and 16.95% had positive urine culture reports. In blood cultures, the most common Gram-positive organism found was , and the most common Gram-negative organism was . In urine cultures, was the most common species. PLA2 was significantly higher in patients with bacterial etiology and Gram-positive cultures. The diagnostic capability, sensitivity, specificity, and accuracy of PLA2 were demonstrably higher than those of PCT.
Our study proves that PLA2 is a much better and more efficient biomarker in sepsis than PCT. The diagnostic capacity and accuracy of PLA2 clearly surpass PCT, so using PLA2 in sepsis as a biomarker can help clinicians in deciding on timely and appropriate management to speed the recovery of patients.
脓毒症是宿主对感染的复杂反应，伴有器官功能衰竭，最终导致宿主死亡。降钙素原（PCT）是用于诊断脓毒症的有效标志物，但迄今为止，尚无理想的脓毒症标志物。磷脂酶A2（PLA2）也会增加感染风险；然而，仅有少数研究评估了其作为脓毒症诊断生物标志物的能力。因此，我们旨在检测PLA2，并将其作为脓毒症生物标志物的诊断能力和准确性与PCT进行比较。
我们的研究是一项以医院为基础的横断面研究。研究组包括80名年龄大于18岁的男女患者，符合快速序贯器官衰竭评估（qSOFA）或全身炎症反应综合征（SIRS）标准且≥2，于2021年1月至2021年12月在印度卡纳塔克邦的一家三级护理医院住院。其中，59例被诊断为脓毒症。对所有患者样本进行相关参数评估，并使用运行在Windows 10系统上的SPSS v21对数据进行统计分析。统计学显著性设定为p值<0.05。
与非脓毒症患者相比，脓毒症患者的平均PCT和PLA2显著升高。在59例脓毒症患者中，45.76%血培养呈阳性，16.95%尿培养报告呈阳性。血培养中，最常见的革兰氏阳性菌是 ，最常见的革兰氏阴性菌是 。尿培养中， 是最常见的菌种。PLA2在细菌病因和革兰氏阳性菌培养的患者中显著更高。PLA2的诊断能力、敏感性、特异性和准确性明显高于PCT。
我们的研究证明，在脓毒症中，PLA2是比PCT更好、更有效的生物标志物。PLA2的诊断能力和准确性明显超过PCT，因此在脓毒症中使用PLA2作为生物标志物可帮助临床医生做出及时、恰当的治疗决策，以加速患者康复。
