Shashidhara K C, Reddy Karnati Prudhveer, Ashok P, Prasad M C
Department of General Medicine, JSS Medical College and Hospital, JSSAHER, Mysore, Karnataka, India.
Ann Afr Med. 2025 Jun 30. doi: 10.4103/aam.aam_1_25.
Sepsis remains a leading cause of mortality in intensive care units (ICUs) worldwide, necessitating improved diagnostic and prognostic tools. This study aimed to estimate the novel sepsis biomarkers, including presepsin, interleukin (IL)-27, hepcidin, and plasma chitotriosidase in ICU patients with sepsis, evaluating their potential for enhancing early diagnosis and monitoring.
This prospective study was conducted over 18 months at JSS Medical College and Hospital, Mysuru, India. The study included 73 ICU patients above 18 years diagnosed with bacterial sepsis based on Quick Sequential Organ Failure Assessment score and procalcitonin (PCT) levels. Blood samples were collected and analyzed using enzyme-linked immunosorbent assay with respective biomarker kits. Demographic data, clinical parameters, and laboratory values were recorded. Correlations between novel biomarkers and PCT were assessed using Pearson correlation analysis.
The study population had a mean age of 55.7 years, with 60.3% male participants. Hypertension (56.16%) and type 2 diabetes mellitus (49.32%) were the most common comorbidities. Abnormal presepsin levels were observed in 53.4% of participants, showing a strong positive correlation with PCT (r = 0.763, P < 0.001). Hepcidin levels were abnormal in 76.7% of participants, demonstrating a moderate positive correlation with PCT (r = 0.522, P < 0.001). Only 11.0% of participants had abnormal IL-27 levels, with a weak, nonsignificant correlation with PCT (r = 0.172, P = 0.540). All participants (100%) had abnormal chitotriosidase levels, showing a weak but significant positive correlation with PCT (r = 0.234, P = 0.047).
This study supports the potential of presepsin and hepcidin as novel biomarkers for sepsis in ICU patients. These markers showed strong correlations with PCT and high rates of abnormal levels in sepsis patients. IL-27 and chitotriosidase showed less promise in our study population. Integrating these novel biomarkers, particularly presepsin and hepcidin, into clinical practice could potentially improve early diagnosis and management of sepsis in critical care settings.
脓毒症仍然是全球重症监护病房（ICU）患者死亡的主要原因，因此需要改进诊断和预后工具。本研究旨在评估新型脓毒症生物标志物，包括可溶性髓系细胞触发受体-1（presepsin）、白细胞介素（IL）-27、铁调素和血浆壳三糖苷酶在ICU脓毒症患者中的作用，评估它们在加强早期诊断和监测方面的潜力。
本前瞻性研究在印度迈索尔市JSS医学院及医院进行，为期18个月。该研究纳入了73名18岁以上的ICU患者，这些患者根据快速序贯器官衰竭评估评分和降钙素原（PCT）水平被诊断为细菌性脓毒症。采集血样并使用相应生物标志物检测试剂盒通过酶联免疫吸附测定法进行分析。记录人口统计学数据、临床参数和实验室值。使用Pearson相关分析评估新型生物标志物与PCT之间的相关性。
研究人群的平均年龄为55.7岁，男性参与者占60.3%。高血压（56.16%）和2型糖尿病（49.32%）是最常见的合并症。53.4%的参与者可溶性髓系细胞触发受体-1水平异常，与PCT呈强正相关（r = 0.763，P < 0.001）。76.7%的参与者铁调素水平异常，与PCT呈中度正相关（r = 0.522，P < 0.001）。只有11.0%的参与者白细胞介素-27水平异常，与PCT呈弱的、无统计学意义的相关性（r = 0.172，P = 0.540）。所有参与者（100%）壳三糖苷酶水平异常，与PCT呈弱但显著的正相关（r = 0.234，P = 0.047）。
本研究支持可溶性髓系细胞触发受体-1和铁调素作为ICU患者脓毒症新型生物标志物的潜力。这些标志物与PCT显示出强相关性，且在脓毒症患者中异常水平发生率高。在我们的研究人群中，白细胞介素-27和壳三糖苷酶的前景较差。将这些新型生物标志物，特别是可溶性髓系细胞触发受体-1和铁调素，整合到临床实践中可能会改善重症监护环境中脓毒症的早期诊断和管理。
