Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 31:16:3963-3976.
doi: 10.2147/IJGM.S415200. eCollection 2023.

Detection of Inflammatory Biomarkers Among Patients with Sepsis of Gram-Negative Bacteria: A Cross-Sectional Study

Thikra Qader Khana  1 , Khanda Abdulateef Anwar  2
Affiliations

Detection of Inflammatory Biomarkers Among Patients with Sepsis of Gram-Negative Bacteria: A Cross-Sectional Study

Thikra Qader Khana et al. Int J Gen Med. .

Abstract

Background: Sepsis is a highly mixed ailment that affects patients with numerous conditions of infectious sources and can lead to multi-organ failure with dysregulated host immune response.

Objective: To determine inflammatory biomarkers in patients with sepsis caused by Gram-negative bacteria and compare their role in the early detection of sepsis.

Methods: This cross-sectional study was conducted on patients with sepsis admitted to the intensive care unit at different hospitals in Sulaimaniyah, Iraq, from May to December 2021. Patients (n=147) were enrolled in this study according to the primary diagnosis of sepsis by Sequential Organ Failure Assessment scores. Blood samples were taken from patients to investigate white blood cells, inflammatory biomarkers (pentraxin-3, procalcitonin, adrenomedullin, lipopolysaccharide binding protein, interleukin-17A, lactate dehydrogenase, and C-creative protein), blood culture, antibiotic susceptibility test, and coagulation biomarkers (Prothrombin time, activated partial thromboplastin time, and international normalized ratio). Then, isolated Gram-negative bacteria were tested for extended-spectrum β-lactamase enzymes production by screening and combined disc tests.

Results: A total of 51.7% samples were blood culture positive for different Gram-negative bacteria, and P. aeruginosa (51.95%) was a more isolated bacterium. Both males and females were affected by sepsis in a ratio of 1.23:1 with different age groups. Extended-spectrum β-lactamase was estimated to be 77.2% by antibiotic profile, and the rate decreased using two double-disc synergy tests. This was confirmed by combined disc test at a rate of 41.35%. The most prevalent biomarkers were procalcitonin (88.16%), adrenomedullin (84.21%), pentraxin-3 (22.37%), and lipopolysaccharide binding protein (11.84%).

Conclusion: Sepsis is a life-threatening condition that can be diagnosed early by several blood biomarkers such as procalcitonin, adrenomedullin, and pentraxin-3 combined with a standard blood culture technique to improve the patient outcome.

Keywords: Gram-negative bacteria; SOFA score; double-disc synergy test; sepsis biomarkers; β-Lactamase.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
Double-disc synergy test 1. Positive test: Enhancement of zone of inhibition from amoxicillin–clavulanic acid towards ceftazidime disc and ceftriaxone disc (black arrow).
Figure 2
Figure 2
Double-disc synergy test 2. Positive test: Enhancement of zone inhibition from ceftazidime–avibactam towards ceftriaxone (black arrow).
Figure 3
Figure 3
ROC curve of biomarkers.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Liu J, Bai C, Li B, et al. Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units. Sci Rep. 2021;11(1):1275. doi:10.1038/s41598-020-79843-5 - DOI - PMC - PubMed
    1. Ahmad S, Ismaeel SM, Mohammed DA, et al. Outcome and management of sepsis at Rozhhalat emergency hospital in Erbil –Kurdistan region of Iraq. J Appl Res. 2018;2018:21–30.
    1. Gudiol C, Albasanz-Puig A, Cuervo G, et al. Understanding and managing sepsis in patients with cancer in the era of antimicrobial resistance. Front Med. 2021;8:636547. doi:10.3389/fmed.2021.636547 - DOI - PMC - PubMed
    1. Venet F, Monneret G. Advances in the understanding and treatment of sepsis-induced immunosuppression. Nat Rev Nephrol. 2018;14(2):121–137. doi:10.1038/nrneph.2017.165 - DOI - PubMed
    1. Hung Y-L, Suzuki K. The pattern recognition receptors and lipopolysaccharides (LPS)-induced systemic inflammation. Int J Med Sci Public Health. 2017;2(7):1–7.

LinkOut - more resources