The predictive role of Interleukin 6 and Procalcitonin associated with bacterial infection causing sepsis in patients with severe burn

Abstract

Background. Sepsis is a major contributor to both death and illness on a worldwide scale. Bacteremia characterized by the presence of gram-negative, gram-positive, or mixed growth bacteria has been shown to be associated with a significantly increased risk of septic shock and a bad prognosis. Biomarkers are used to aid in the diagnosis of sepsis and to differentiate between bacterial causes, namely Gram-negative, Gram-positive, and mix growth bacteria. Objectives. This study aimed to evaluate the role of PCT and IL-6 in predicting bacterial infection in burn patients with sepsis due to gram-negative, gram positive and mixed growth bacteria. Methods. Forty-four patients with age (1.5–75 years), and nineteen healthy controls with the same age range, were involved in this study during their attendance to Specialized Burns Hospital in the Medical City, Al-Kindi Teaching Hospital in Baghdad, and Al-Nasiriyah General Hospital in Thi-Qar province. The study was conducted from 1st December 2023 to 1st April 2024 and approved by ethical committees of Institute of Genetic Engineering and Biotechnology for Postgraduate Studies/ Baghdad University. Blood samples and data were collected to evaluate the level of PCT and IL-6 associated with bacterial infection for burn patients by enzyme linked immunosorbent assay (ELISA). Results. 25 (50%) showed growth for Gram-negative, 13 (26%) for Gram-positive and 12 (24%) for mix growth bacteria. Results appeared a significant increase at (P≤0.01) in each of PCT and IL-6 in burn patients to control group according to gender. Patients exhibiting a combination of bacterial growth have notably elevated levels of procalcitonin (PCT). Levels of PCT were significantly elevated in burn patients with mixed growth sepsis compared to patients with Gram-negative and Gram-positive sepsis. However, there were no significant differences in IL-6 levels between burn patients with mix growth sepsis and patients with gram-negative and gram-positive sepsis (P> 0.05). Measuring PCT levels may assist in selecting the appropriate empirical antibiotic treatment. Conclusions. The PCT biomarker demonstrated superior performance in distinguishing between microbial sepsis caused by various kinds of pathogens. This finding has great promise for its use in clinical practice, particularly in burn units.