title: Macrophage migration inhibitory factor is associated with positive cultures in patients with sepsis after cardiac surgery.
abstract: This prospective consecutive observational study describes the blood levels of macrophage migration inhibitory factor (MIF), other cytokines, and markers of acute-phase response in 49 consecutive patients who developed the clinical syndrome of sepsis after cardiac surgery. Before starting antimicrobial treatment, all patients underwent microbiologic screening, and blood samples were collected. These samples subsequently were assayed for MIF, macrophage chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6 and -10, procalcitonin (PCT), and C-reactive protein (CRP). Patients with positive cultures (n = 25) had a higher mortality (P = 0.046) and higher levels of MIF (P < 0.001) than those with negative cultures (n = 24). We could not detect significant difference between the groups concerning the levels of CRP, PCT, IL6, IL10, MCP-1, or TNF-alpha. MIF levels showed an area under receiver operator curve of 0.823 for the prediction of culture-proven bacterial infection, with the best cut-off value at 988.5 pg/mL. In conclusion, circulating levels of MIF could be indicated as a valuable marker of microbiologically documented sepsis in patients after cardiac surgery, which suggests that MIF may be prospectively explored as a useful diagnostic tool in this setting.
authors.affiliation: Hospital Pro Cardíaco, Rio de Janeiro, 22280-000 Brazil. immunobiologia@procardiaco.com.br
authors.forename: Hugo Tannus Furtado
authors.initials: HT
authors.lastname: de Mendonça-Filho
authors.forename: Gleice Silva
authors.initials: GS
authors.lastname: Gomes
authors.forename: Pedro Miguel Mattos
authors.initials: PM
authors.lastname: Nogueira
authors.forename: Marco Aurelio de Oliveira
authors.initials: MA
authors.lastname: Fernandes
authors.forename: Bernardo Rangel
authors.initials: BR
authors.lastname: Tura
authors.forename: Marisa
authors.initials: M
authors.lastname: Santos
authors.forename: Hugo Caire
authors.initials: HC
authors.lastname: Castro-Faria-Neto
mesh_terms: D000210:Acute-Phase Reaction; D000368:Aged; D000890:Anti-Infective Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D018932:Chemokine CCL2 / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications; D011498:Protein Precursors / Q000378:metabolism; D012372:ROC Curve; D018805:Sepsis / Q000378:metabolism*; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000890:Anti-Infective Agents; C000606589:CALCA protein, human; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016207:Cytokines; D015850:Interleukin-6; D008263:Macrophage Migration-Inhibitory Factors; D011498:Protein Precursors; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide