Neutrophil function in surgical patients. Relationship to adequate bacterial defenses.

Chemotaxis under agarose and the beta-glucosaminidase enzyme-release assay (BGERA) were evaluated for assessing neutrophil function in 44 patients in a surgical intensive care unit (SICU). The 27 patients shown to be angeric to delayed-type hypersensitivity skin tests at entry to the SICU had decreased neutrophil chemotaxis of 2.6 +/- 0.2 cm (mean +/- SEM) and a decreased BGERA result of 22.4% +/- 1.6%. Major sepsis developed in 59% of them, and 44% died. The ten relatively anergic patients (reacting to one antigen) had a normal neutrophil chemotactic response of 3.0 +/- 0.2 cm and a decreased BGERA result of 20.9% +/- 1.6%. Sepsis developed in 30% of them, and 20% died. The seven reactive patients (reacting to two or more antigens) had a neutrophil chemotaxis of 3.7 +/- 0.3 cm and a BGERA result of 18.9% +/- 1.7%. None had sepsis or died. The agarose method correlated best with the delayed-type hypersensitivity response. The BGERA results did not correlate with neutrophil chemotaxis and were not helpful in gauging neutrophil function.