Macrophage migration inhibitory factor is associated with positive cultures in patients with sepsis after cardiac surgery.
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.
de Mendonça-Filho
Hugo Tannus Furtado
HT
Hospital Pro Cardíaco, Rio de Janeiro, 22280-000 Brazil. immunobiologia@procardiaco.com.br
Gomes
Gleice Silva
GS
Nogueira
Pedro Miguel Mattos
PM
Fernandes
Marco Aurelio de Oliveira
MA
Tura
Bernardo Rangel
BR
Santos
Marisa
M
Castro-Faria-Neto
Hugo Caire
HC
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
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