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Abstract

Introduction: Healthcare Associated Infections (HAI) are associated with increased cost, morbidity, and mortality. Risk factors for HAI are well established; however, the independent risk associated with an exaggerated inflammatory response has not been adequately studied. Hypothesis: The objective was to investigate baseline cytokine levels (IL-6, IL-10), their polymorphisms (RS1800795, RS1800896) and environment on the development of new HAI in ICU patients admitted with sepsis. Methods: This prospective observational study evaluated 78 patients admitted to ICU with early sepsis ( Results: Seventeen HAI were identified. The final regression model included APACHE II, invasive device score, antibiotics prior to ICU, and IL6 RS1800795. Based on the multivariate model, for every 1-point increase in APACHE II score there was a 3.4% increased risk for developing HAI. Cumulative invasive device score and early antibiotic use reduced the risk of HAI. In the univariate model, the presence of IL6 polymorphism RS1800795 CC or CG resulted in a higher risk of HAI, and this risk increased in the multivariate model. Conclusions: The higher risk associated with IL-6 polymorphism RS1800795 CG and CC genotypes is consistent with higher risk associated with the C allele reported in the literature. Severity of illness is a known contributor to HAI. Sepsis guideline adherence (early antibiotics and judicious device use) may prevent HAI. We found no significant association with cytokine levels in our models. More analysis with a larger sample is needed to fully explore the relationships of these variables.