Abstract
We previously reported that a soluble CD14-subtype (sCD14-ST) immunochromatographic test (ICT) for plasma is more convenient than chemiluminescent enzyme immunoassay (CLEIA), but plasma separation makes bedside measurements difficult. We developed a new sCD14-ST ICT for whole blood and investigated whether quantitative determinations of sCD14-ST by ICT were useful for diagnosing sepsis and severe sepsis/septic shock. We studied 20 patients who fulfilled two or more systemic inflammatory response syndrome (SIRS) criteria and 32 patients who had been diagnosed with sepsis or severe sepsis/septic shock. Whole blood was collected on day 0 (on admission) and day 7, and the sCD14-ST concentration was quantitatively measured by CLEIA and ICT for whole blood. The patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA), and Mortality in Emergency Department Sepsis (MEDS) scores were also calculated. The cut-off values obtained by the quantitative measurements made by ICT were 464.5 pg/mL for sepsis and 762.7 pg/mL for severe sepsis/septic shock (P < 0.0001). A Bland–Altman plot showed that no fixed bias or proportional bias was detected between CLEIA and quantitative ICT for whole blood. sCD14-ST concentrations were significantly correlated with APACHE II, SOFA, and MEDS scores (P < 0.0001). These results suggest that the new sCD14-ST ICT for whole blood may be a useful tool for the convenient, rapid bedside diagnosis and treatment of sepsis.
Highlights
Sepsis is a toxic systemic response to infection that progresses to the even more serious conditions of severe sepsis and septic shock accompanied by organ dysfunction [1]
We investigated whether quantitative determinations of sCD14-ST by immunochromatographic test (ICT) for whole blood would be useful for diagnosing sepsis and severe sepsis/septic shock and whether its quantitative capacity is similar to that provided by chemiluminescent enzyme immunoassay (CLEIA)
We studied 52 patients (31 males and 21 females) who fulfilled two or more of the diagnostic criteria for systemic inflammatory response syndrome (SIRS) or who were diagnosed with sepsis or severe sepsis/septic shock and were admitted to our department
Summary
Sepsis is a toxic systemic response to infection that progresses to the even more serious conditions of severe sepsis and septic shock accompanied by organ dysfunction [1]. According to the Surviving Sepsis Campaign Guidelines 2012 (SSCG 2012), mortality rates are higher when antimicrobial agents have been administered after septic shock has developed. PCT, in particular, has been reported to be superior to endotoxin, β-D-glucan, IL-6, and C-reactive protein for differentiating between bacterial infections, including sepsis, and non-bacterial infections [3]. PCT is known to be increased in non-infectious systemic inflammatory response syndrome (SIRS) [4,5,6,7], and differentiating between non-infectious SIRS and infectious SIRS can be difficult [8]
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