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Multicenter Study
. 2019 Jul;38(7):1279-1286.
doi: 10.1007/s10096-019-03543-w. Epub 2019 Apr 13.

The impact of bacteremia on lipoprotein concentrations and patient's outcome: a retrospective analysis

Alex Pizzini  1 , Katharina Kurz  1 , Dorothea Orth-Hoeller  2 , Manfred Fille  2 , Jasmin Rabensteiner  3 , Fabian Lunger  4 , Lukas Lunger  5 , Christoph Tschurtschenthaler  1 , Ivan Tancevski  1 , Robert Krause  3 , Cornelia Lass-Floerl  2 , Günter Weiss  1 , Rosa Bellmann-Weiler  6
Affiliations
Multicenter Study

The impact of bacteremia on lipoprotein concentrations and patient's outcome: a retrospective analysis

Alex Pizzini et al. Eur J Clin Microbiol Infect Dis. 2019 Jul.

Abstract

Bacteremia is a major clinical challenge requiring early treatment. Metabolic alterations occur during bacteremia, and accordingly plasma concentrations of lipoproteins LDL-C and HDL-C are substantially changed. We questioned whether bacteremia with Gram-negative versus Gram-positive bacteria causes contrasting changes of lipoprotein levels in order to differentiate between the 2-g stain types and if there is a relation with outcome parameters namely ICU-admission, 30-day mortality, duration of hospitalization. This is a retrospective dual-center cross-sectional study, including 258 patients with bacteremia. Plasma lipid levels were analyzed within 48 h to positive blood culture. Upon admission, HDL-C, LDL-C, and total cholesterol (p = 0.99) in plasma did not significantly differ between patients with Gram-negative and Gram-positive bacteremia, while significantly higher triglyceride concentrations were found in Gram-negative bacteremia (p < 0.05). 30-day mortality and ICU admission were associated with lower LDL-C and HDL-C concentrations as compared to survivors and non-ICU patients, and patients with HDL-C < 20 mg dl-1 and LDL-C < 55 mg dl-1 had a relative risk (RR) of 2.85 for ICU therapy requirement and RR = 2 of death within 30 days. Reduced HDL-C and LDL-C concentrations were associated with adverse patient's outcome in bacteremia. Discrimination between Gram-negative and Gram-positive pathogens upon lipoprotein patterns is unlikely.

Keywords: Bacteremia; Gram species; HDL; LDL; Lipoprotein; Triglycerides.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Fig. 1
Fig. 1
Lipoprotein concentrations in patients with Gram-positive and Gram-negative bacteremia determined within 2 days after hospital admission; groups were compared using Mann-Whitney U test. *Significance at p value < 0.05. n.s. not significant, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, TG triglycerides, Chol total cholesterol
Fig. 2
Fig. 2
Inflammatory parameters in patients with Gram-negative and Gram-positive bacteremia determined within 2 days after hospital admission; groups were compared using Mann-Whitney U test. *Significance at p value < 0.05. n.s. not significant, WBC white blood cells, CRP C-reactive protein, PCT procalcitonin
Fig. 3
Fig. 3
Lipoprotein concentrations of patients who died within < 30 days versus survival > 30 days. Groups were compared using Mann-Whitney U test. *Significance at p value < 0.05. n.s. not significant, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, TG triglycerides, Chol total cholesterol
Fig. 4
Fig. 4
Lipoprotein concentrations of patients requiring ICU treatment. Groups were compared using Mann-Whitney U test. *Significance at p value < 0.05. ICU intensive care unit, n.s. not significant, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol, TG triglycerides, Chol total cholesterol
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References

    1. Laupland KB. Incidence of bloodstream infection: a review of population-based studies. Clin Microbiol Infect. 2013;19(6):492–500. doi: 10.1111/1469-0691.12144. - DOI - PubMed
    1. Nielsen SL (2015) The incidence and prognosis of patients with bacteremia. Dan Med J 62(7) - PubMed
    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3) JAMA. 2016;315(8):801–810. doi: 10.1001/jama.2016.0287. - DOI - PMC - PubMed
    1. Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D, Sepsis occurrence in acutely ill patients I Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34(2):344–353. doi: 10.1097/01.CCM.0000194725.48928.3A. - DOI - PubMed
    1. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304–377. doi: 10.1007/s00134-017-4683-6. - DOI - PubMed

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