title: The plasma level of soluble urokinase receptor is elevated in patients with Streptococcus pneumoniae bacteraemia and predicts mortality.
abstract: This multicentre prospective study was conducted to investigate whether the level of the soluble form of urokinase-type plasminogen activator receptor (suPAR) is elevated during pneumococcal bacteraemia and is of predictive value in the early stage of the disease. Plasma levels of suPAR were increased significantly (median 5.5; range 2.4-21.0 ng/mL) in 141 patients with pneumococcal bacteraemia, compared to 31 healthy controls (median 2.6, range 1.5-4.0 ng/mL, p 0.001). Furthermore, suPAR levels were elevated significantly in patients who died from the infection (n = 24) compared to survivors (n = 117; p < 0.001). No correlation was found between suPAR levels and C-reactive protein. In univariate logistic regression analysis, hypotension, renal failure, cerebral symptoms and high serum concentrations of protein YKL-40 and suPAR were associated significantly with mortality (p < 0.05). In multivariate analysis, only suPAR remained a significant predictor of death (mortality rate of 13 for suPAR levels of > 10 ng/mL; 95% CI: 1.1-158). The increase in suPAR levels may reflect increased expression by vascular or inflammatory cells in the setting of pneumococcal sepsis. This plasma protein may be used to identify patients who are severely ill with pneumococcal bacteraemia.
authors.affiliation: Clinical Research Unit, Copenhagen University Hospitals, Hvidovre, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Wittenhagen
authors.forename: G
authors.initials: G
authors.lastname: Kronborg
authors.forename: N
authors.initials: N
authors.lastname: Weis
authors.forename: H
authors.initials: H
authors.lastname: Nielsen
authors.forename: N
authors.initials: N
authors.lastname: Obel
authors.forename: S S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: J
authors.initials: J
authors.lastname: Eugen-Olsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood* / Q000382:microbiology / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011008:Pneumococcal Infections / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D011956:Receptors, Cell Surface / Q000097:blood*; D055293:Receptors, Urokinase Plasminogen Activator; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012995:Solubility; D013296:Streptococcus pneumoniae / Q000472:pathogenicity*; D016019:Survival Analysis; D014568:Urokinase-Type Plasminogen Activator
chemical_list: C524898:PLAUR protein, human; D011956:Receptors, Cell Surface; D055293:Receptors, Urokinase Plasminogen Activator; D002097:C-Reactive Protein; D014568:Urokinase-Type Plasminogen Activator