OBJECTIVE: To determine the value of serum concentrations of interleukin-6 (IL-6), C-reactive protein, and glycosylation of alpha 1-acid glycoprotein as tools for diagnosing nosocomial infection in surgical intensive care unit (ICU) patients. DESIGN: Prospective, consecutive entry study of patients with an anticipated stay of at least 24 hrs in a surgical ICU. SETTING: University hospital, a major provider of acute surgical care. PATIENTS: One hundred four consecutive patients admitted to the surgical ICU between March and June 1990. MEASUREMENTS: Concentrations of IL-6, C-reactive protein, and glycosylation of alpha 1-acid glycoprotein were measured on days 1 and 6 after ICU admission. Clinical evaluation for infection was performed daily in a blinded fashion, i.e., without knowing the results of the acute-phase parameters. MAIN RESULTS: On day 6 after surgery or trauma, nosocomial infection could be ascertained in 13 cases. The clinical parameter of fever > 38 degrees C had a sensitivity of 54% and a specificity of 90% to demonstrate nosocomial infection. Infected patients showed increased concentrations of IL-6 (p < .001), C-reactive protein (p < .001), and increased reactivity of alpha 1-acid glycoprotein to concanavalin A (p < .001) compared with patients without infections. By choosing appropriate cutoff values, IL-6 determinations had the highest specificity (97%), and C-reactive protein values had the highest sensitivity (85%) for diagnosing nosocomial infections. In uninfected patients, 81% of the IL-6 values, but only 29% of the C-reactive protein values, were back to the normal range on day 6 after injury. CONCLUSION: Due to the rapid normalization after trauma, a single measurement of the serum IL-6 concentration may be useful to support or refute the clinical suspicion of nosocomial infection.
OBJECTIVE: To determine the value of serum concentrations of interleukin-6 (IL-6), C-reactive protein, and glycosylation of alpha 1-acid glycoprotein as tools for diagnosing nosocomial infection in surgical intensive care unit (ICU) patients. DESIGN: Prospective, consecutive entry study of patients with an anticipated stay of at least 24 hrs in a surgical ICU. SETTING: University hospital, a major provider of acute surgical care. PATIENTS: One hundred four consecutive patients admitted to the surgical ICU between March and June 1990. MEASUREMENTS: Concentrations of IL-6, C-reactive protein, and glycosylation of alpha 1-acid glycoprotein were measured on days 1 and 6 after ICU admission. Clinical evaluation for infection was performed daily in a blinded fashion, i.e., without knowing the results of the acute-phase parameters. MAIN RESULTS: On day 6 after surgery or trauma, nosocomial infection could be ascertained in 13 cases. The clinical parameter of fever > 38 degrees C had a sensitivity of 54% and a specificity of 90% to demonstrate nosocomial infection. Infected patients showed increased concentrations of IL-6 (p < .001), C-reactive protein (p < .001), and increased reactivity of alpha 1-acid glycoprotein to concanavalin A (p < .001) compared with patients without infections. By choosing appropriate cutoff values, IL-6 determinations had the highest specificity (97%), and C-reactive protein values had the highest sensitivity (85%) for diagnosing nosocomial infections. In uninfected patients, 81% of the IL-6 values, but only 29% of the C-reactive protein values, were back to the normal range on day 6 after injury. CONCLUSION: Due to the rapid normalization after trauma, a single measurement of the serum IL-6 concentration may be useful to support or refute the clinical suspicion of nosocomial infection.
Authors: F B Taylor; V L Tesh; L DeBault; A Li; A C Chang; S D Kosanke; T J Pysher; R L Siegler Journal: Am J Pathol Date: 1999-04 Impact factor: 4.307
Authors: Thorsten Brenner; Claudia Rosenhagen; Jochen Steppan; Christoph Lichtenstern; Jürgen Weitz; Thomas Bruckner; Eike O Martin; Ursula Hoffmann; Markus A Weigand; Stefan Hofer Journal: Mediators Inflamm Date: 2010-08-05 Impact factor: 4.711
Authors: Rafael Sierra; Jordi Rello; María Angeles Bailén; Encarnación Benítez; Antonio Gordillo; Cristobal León; Sebastián Pedraza Journal: Intensive Care Med Date: 2004-09-11 Impact factor: 17.440
Authors: Gian Paolo Castelli; Claudio Pognani; Michael Meisner; Antonio Stuani; Daniela Bellomi; Laura Sgarbi Journal: Crit Care Date: 2004-06-10 Impact factor: 9.097