suPAR remains uninfluenced by surgery in septic patients with bloodstream infection

Abstract

Surgical trauma induces activation of the immune system and may cause an increase of inflammatory biomarkers tested postoperatively in septic patients treated for bloodstream infection. The aim of this study was to determine the impact of surgical interventions on the novel sepsis biomarker soluble urokinase plasminogen activator receptor (suPAR) and to compare results with those of routine laboratory parameters CRP, PCT, and IL-6 in patients with culture-proven bloodstream infection. Forty-six adult patients with positive blood culture undergoing minor or major surgical intervention were investigated, 12 blood culture positive patients served as control group. Blood was collected 24 hours before and after surgical intervention for determination of the sepsis biomarkers suPAR, CRP, PCT, and IL-6. Within the surgical study cohort, a non-significant increase of suPAR, CRP, and PCT was observed postoperatively ( 0.642; 0.773; 0.087). In contrast, a slight decrease of IL-6 ( 0.599) was observed. A significant correlation was calculated for the pre- and postoperative difference of CRP ( 0.028) and PCT and type of surgical intervention received: after minor surgical intervention only PCT decreased significantly (<0.001), while after major surgical interventions no significant differences were observed for all biomarkers evaluated. In the control group, a significant decrease of CRP ( 0.005) and PCT ( 0.005) was observed. In patients treated adequately for bloodstream infections, postoperative suPAR levels remained uninfluenced of the surgical trauma and might therefore be a reliable parameter for postoperative infectious monitoring. After minor surgical intervention, PCT seems to be the most reliable parameter.

Keywords

• sepsis biomarker
• surgical intervention
• soluble urokinase plasminogen activator receptor (suPAR)
• procalcitonin (PCT)
• interleukin-6 (IL-6)
• C-reactive protein (CRP)