Measurement of granulocyte colony-stimulating factor and IL-6, IL-8 and IL-10 as an early predictor for septic patients

Introduction

Despite the great evolution in the treatment modalities of sepsis, there is an unsatisfactory improvement in the mortality rate. Cytokines play an important role in occurrence of SIRS, sepsis and multiple organ failure. A series of proinflammatory cytokines such as IL-1, IL-6, and IL-8 are secreted early in sepsis followed by another group of anti-inflammatory cytokines such as IL-10 and granulocyte colony-stimulating factor (G-CSF).

Objective

This study was carried out to find the benefit of early measurement of serum IL-6, IL-8, IL-10 and G-CSF for diagnosis of sepsis and its impact on patient outcomes in septic patients.

Patients and methods

Eighty patients (50 males and 30 females) fulfilling the criteria of SIRS were categorized on admission according to ACCP&SCCM definition into four groups: SIRS (26 patients), septic patients (26 patients), severe sepsis (14 patients), and septic shock (14 patients). Their age ranged between 19 and 75 with a mean of 48.65 ± 17.33 years. IL-6 and IL-8 were measured using ELISA and G-CSF using the immunoassay technique at day 0 and after 48 hours. Culture from the site of any infection was done at day 0 and at any time during patient stay if severe signs of infection or septicemia developed. CBC, blood gases and chest X-ray, APACHE II score and MOSD were done daily.

Results

Chest infection was the most common site of infection (48 patients, 60%), followed by mixed wound infection (10 patients, 12.5%) and abdominal sepsis (six patients, 7.5%), two patients with urosepsis (2.5%) and source of infection can found in four patients (5%).

A significant positive correlation was found between cytokine levels, the scoring systems and blood cultures in the four groups.

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