Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study - Université de Versailles Saint-Quentin-en-Yvelines Access content directly
Journal Articles Intensive Care Medicine Year : 2018

Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study

Marianna Parlato
François Philippart
  • Function : Author
Alexandra Rouquette
  • Function : Author
Virginie Moucadel
  • Function : Author
Virginie Puchois
  • Function : Author
Sophie Blein
  • Function : Author
Jean-Pierre Bedos
  • Function : Author
Jean-Luc Diehl
  • Function : Author
Olfa Hamzaoui
  • Function : Author
Didier Journois
  • Function : Author
Myriam Ben Boutieb
  • Function : Author
Laurent Estève
  • Function : Author
Catherine Fitting
  • Function : Author
Jean-Marc Treluyer
  • Function : Author
Alexandre Pachot
  • Function : Author
Minou Adib-Conquy
  • Function : Author
Jean-Marc Cavaillon
  • Function : Author
Benoît Misset
  • Function : Author

Abstract

Purpose Sepsis and non-septic systemic inflammatory response syndrome (SIRS) are the same syndromes, differing by their cause, sepsis being secondary to microbial infection. Microbiological tests are not enough to detect infection early. While more than 50 biomarkers have been proposed to detect infection, none have been repeatedly validated. Aim To assess the accuracy of circulating biomarkers to discriminate between sepsis and non-septic SIRS. Methods The CAPTAIN study was a prospective observational multicenter cohort of 279 ICU patients with hypo- or hyperthermia and criteria of SIRS, included at the time the attending physician considered antimicrobial therapy. Investigators collected blood at inclusion to measure 29 plasma compounds and ten whole blood RNAs, and—for those patients included within working hours—14 leukocyte surface markers. Patients were classified as having sepsis or non-septic SIRS blindly to the biomarkers results. We used the LASSO method as the technique of multivariate analysis, because of the large number of biomarkers. Results During the study period, 363 patients with SIRS were screened, 84 having exclusion criteria. Ninety-one patients were classified as having non-septic SIRS and 188 as having sepsis. Eight biomarkers had an area under the receiver operating curve (ROC-AUC) over 0.6 with a 95% confidence interval over 0.5. LASSO regression identified CRP and HLA-DRA mRNA as being repeatedly associated with sepsis, and no model performed better than CRP alone (ROC-AUC 0.76 [0.68–0.84]). Conclusions The circulating biomarkers tested were found to discriminate poorly between sepsis and non-septic SIRS, and no combination performed better than CRP alone

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Health

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hal-04534029 , version 1 (05-04-2024)

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Marianna Parlato, François Philippart, Alexandra Rouquette, Virginie Moucadel, Virginie Puchois, et al.. Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study. Intensive Care Medicine, 2018, 44 (7), pp.1061-1070. ⟨10.1007/s00134-018-5228-3⟩. ⟨hal-04534029⟩
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