- Poster presentation
- Open access
- Published:
Level of lipopolysaccharide-binding protein and microbial landscape with account of severity of sepsis syndromes in polytrauma
Critical Care volume 17, Article number: P291 (2013)
Introduction
The aim was estimation of the clinical and predictive significance of the level of lipopolysaccharide-binding protein (LBP) in blood serum and examination of microbial landscape with account of severity of sepsis syndromes in polytrauma.
Methods
Clinical examination was performed, which included 99 patients with polytrauma according to sepsis syndrome: SIRS (n = 18), local infection (n = 36), sepsis (n = 27), severe sepsis (n = 12), septic shock (n = 6) to the criteria of ACCP/SCCM. The microorganism identification was performed using iEMS Reader MF (Labsystems) with the La Chema multimicrotests. The content of LBP in blood serum was assessed with IMMULITE ONE (USA) with the reagents DPC (USA). Statistical analysis of the data was performed with Statistica 6.0. The numerical characteristics of variables are presented as Me (LQ to UQ). The analysis of differences was carried with the Kruskal-Wallis test for multiple comparison of independent groups, with Friedman one-way analysis of variance. The differences were statistically significant with P < 0.05.
Results
In 81% of the critically ill patients with polytrauma the post-traumatic period was accompanied with development of infectious complications, Gram-negative (K. pneumoniae, Acinetobacter spp., E. coli) and Gram-positive (S. Epidermidis, S. aureus). Sepsis was diagnosed on 8 to 10 days in 45% of the patients. The significant increase of LPS-BP was found in the first 3 days of the follow-up, compared with the control values (6.7 times higher in SIRS group (χ2(n = 18, df = 3) = 52.8666, P < 0.001); 9.9 times higher in the group with local infection (χ2(n = 36, df = 3) = 91.6629, P < 0.001); 15.2 times higher in the sepsis group; 20.5 times higher in the severe sepsis group; 47.3 times higher in the septic shock group (χ2(n = 6, df = 3) = 11.0339, P = 0.0115)), whereas the first positive results of the microbiological examination were obtained only on 5 to 7 days. The diagnostic sensitivity of threshold concentration of LBP in blood serum (335 mkg/ml) was 84%, diagnostic specificity was 88% (ROC curve: 0.88).
Conclusion
The high incidence of the diagnostic levels of LBP in blood serum in patients with sepsis in the early term, before microbiological confirmation of infection, allows one to use this parameter as an early marker of development of purulent septic complications conditioned by Gram-negative microflora.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Ustyantseva, I., Khokhlova, O., Petukhova, O. et al. Level of lipopolysaccharide-binding protein and microbial landscape with account of severity of sepsis syndromes in polytrauma. Crit Care 17 (Suppl 2), P291 (2013). https://doi.org/10.1186/cc12229
Published:
DOI: https://doi.org/10.1186/cc12229