Abstract
Here, we concurrently measured the endotoxin activity (EA) level and levels of multiple biomarkers in patient blood obtained within 24 h after being admitted into the intensive care unit (ICU) and analyzed whether there were links between these markers and their associations with patient conditions and outcomes. The EA levels highly correlated with disease severity and patient survival, and showed a significant positive association with levels of lactate, procalcitonin, presepsin, and interleukin-6. Notably, the EA level was the marker that most highly correlated with the results of blood culture, and the presepsin level was the marker most highly correlated with the survival outcome at 28 days. Thus, the optimal biomarker should be selected based on whether it will be used to discriminate the presence of an infection or to predict survival.
Highlights
Endotoxin, a membrane component of Gram-negative bacteria, plays a key role in the pathogenesis of sepsis [1,2]
The results indicate that endotoxin activity (EA) levels highly correlated with disease severity and patient outcome and that EA levels showed a significant positive association with levels of lactate, PCT, presepsin, and IL-6
We found that the EA level highly correlated with the presence or absence of infection, but there was no difference in the EA level between Gram-negative bacterial infection and Gram-positive bacterial infection
Summary
A membrane component of Gram-negative bacteria, plays a key role in the pathogenesis of sepsis [1,2]. Endotoxin flows into the blood due to bacterial infection or bacterial translocation, associated with a failure of the intestinal barrier and causes various inflammatory responses. Various blood biomarkers have previously been evaluated for the purpose of diagnosing sepsis or predicting its prognosis. Lactate levels can be used as a marker for systemic tissue hypoperfusion in patients with circulatory shock. It is included in the clinical criteria for septic shock defined in the Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3) [4]. White blood cell count (WBC) and C-reactive protein (CRP)
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