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CC BY-NC-ND 4.0 · J Lab Physicians 2015; 7(01): 026-031
DOI: 10.4103/0974-2727.154785
Original Article

Depressed Monocytic Activity may be a Predictor for Sepsis

Nidhi Bhardwaj
Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Purva Mathur
Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Subodh Kumar
Department of Surgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Amit Gupta
Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Gupta
Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Nibu V John
Department of Hospital Infection Control Unit, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Prince Varghese
Department of Hospital Infection Control Unit, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
,
Mahesh Chandra Misra
Department of Surgrical Disciplines, All India Institute of Medical Sciences, New Delhi, India
› Institutsangaben Source of Support: Nil.
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ABSTRACT

Introduction: Trauma is one of the leading causes of mortality worldwide with infections as important causes of death in such patients. Bacterial infections cause activation of monocytes with excessive synthesis of pro-inflammatory cytokines. Hence, this prospective study was conducted to assess the activity of monocytes in traumatized sepsis patients using flow cytometry and to assess if they have any prognostic potential.

Materials and Methods: A total of 16 consecutive trauma patients with sepsis and having positive blood culture were enrolled, along with four healthy controls during the period of March 2013 to July 2013. Blood from septic patients were collected on the same day when blood culture was positive and on days 2 and 5 thereafter. Surface staining for monocytes with CD14 and intracellular staining for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) was done and results were analyzed by flow cytometer. Procalcitonin (PCT) assay was done using MiniVidas. Complete clinical follow-up was done for the patients.

Results: Of the 16 patients, four died due to infections by various microorganisms. Isolated abdominal trauma (25%) was the most common injury among the enrolled patients of sepsis. Levels of TNF-α were significantly decreased when stimulated with lipopolysaccharide in the fatal patients as compared to the healthy controls. Patients having sepsis who survived had an increased level of TNF-α during the follow-up periods.

Conclusion: This study showed that activity of monocytes to produce TNF-α and IL-6 were reduced in severe sepsis. Early identification of such immune-paralysis can help in earlier intervention to salvage this vulnerable trauma population.

Key words

Interleukin-6 - monocytes - sepsis - trauma - tumor necrosis factor-alpha


Publikationsverlauf

Artikel online veröffentlicht:
19. April 2020

© 2015.

Thieme Medical and Scientific Publishers Private Ltd.
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