Kinetics of Myristic Acid Following Accidentally Induced Septic Response

Roman Zazula,Martin Müller,František Pehal,Tomáš Nejtek,Miroslav Průcha,Kseniya Dryahina,Michal Moravec

doi:10.14712/23362936.2019.15

Abstract

Myristic acid was identified as a metabolite with the highest diagnostic sensitivity and specificity in the metabolome of patients with bacteraemia. Subsequently, its significant decrease was observed in patients in septic shock not responding to treatment. In our study we have captured myristic acid serum level kinetics in 96 hours following accidental intravenous self-administration of eubiotic Hylak forte causing infection-like systemic inflammatory response syndrome (SIRS). To our knowledge, this is the first time the kinetics of myristic acid levels is presented in a septic patient. Myristic acid was evaluated in comparison with other inflammatory biomarkers and with its level in a control group of healthy subjects. Myristic acid levels during septic response were significantly elevated in comparison with the control group. The peak level was recorded almost immediately after the insult with a gradual decrease within 96 hours. Myristic acid appears to be a promising biomarker in sepsis diagnostics, further research by our group into this topic is ongoing.

Highlights

Clinical features are still the cornerstone in diagnosis of sepsis, there are various biomarkers which can help physicians to confirm or question the diagnosis (Prucha et al, 2015)
Study of Kauppi et al (2016) identified myristic acid as a metabolite with the highest sensitivity of 1.00 (CI – confidence interval) and specificity of 0.95 in the metabolome of septic patients with bacteraemia
We present a rare case of sepsis-like inflammatory response to accidental intravenous administration of the Hylak forte eubiotic preparation with evaluation of the kinetics of several biomarkers including myristic acid

Summary

Introduction

Clinical features are still the cornerstone in diagnosis of sepsis, there are various biomarkers which can help physicians to confirm or question the diagnosis (Prucha et al, 2015). We present a rare case of sepsis-like inflammatory response to accidental intravenous administration of the Hylak forte eubiotic preparation (germfree concentrate of metabolites of Escherichia coli, Enterococcus faecalis, Lactobacillus acidophils and Lactobacillus helvetici) with evaluation of the kinetics of several biomarkers including myristic acid. To our knowledge, this is the first time the kinetics of myristic acid serum levels following septic insult are being described. Case report A 30-year-old woman with no significant medical history was admitted to the Department of Gynaecology with suspected infection from uterine myoma necrosis Monitored following the Hylak injection, exhibited a second mild peak 24 hours after the insult (Figure 1)

Discussion

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Conclusion