Serum hydrogen sulfide as a novel marker predicting bacterial involvement in patients with community-acquired lower respiratory tract infections.
OBJECTIVE
Endogenous hydrogen sulfide (H2S) may be involved in the pathogenesis of systemic inflammation. It was investigated whether serum H2S levels differed among patients with community-acquired pneumonia, those with exacerbations of COPD or control subjects, and whether H2S may be used as a surrogate marker of the need for antibiotic treatment.


METHODS
Serum H2S levels were measured in 129 patients with pneumonia or COPD exacerbations and in 72 healthy control subjects.


RESULTS
The mean serum H2S concentration was 36% lower in patients with pneumonia (22.7 +/- 14.6 micromol/L) than in control subjects (35.4 +/- 5.3 micromol/L) (P < 0.01). Serum H2S concentration did not differ between patients with acute exacerbations of COPD (33.8 +/- 18.6 micromol/L) and control subjects. Within the COPD group, patients with Anthonisen type 1 exacerbations had a lower serum H(2)S concentration (22.5 +/- 11.6 micromol/L) than control subjects, and those with type 3 exacerbations had a higher serum H2S concentration (54.2 +/- 21.3 micromol/L) than control subjects. There was no difference between patients with type 2 exacerbations (41.7 +/- 8.4 micromol/L) and control subjects. In patients requiring antibiotics, serum H2S concentration was 41% lower than in those not requiring antibiotics. The area under the receiver operating characteristic curve for H(2)S as a surrogate marker of the need for antibiotics was 0.862 (95% confidence interval: 0.805-0.919, P < 0.01). Serum H2S levels were inversely correlated with serum CRP levels (r = -0.337, P < 0.01).


CONCLUSIONS
Serum H2S levels may be used as a marker in lower respiratory tract infections. Further studies are required to validate the role of serum H2S levels in guiding antibiotic selection.
Chen
Ya-Hong
YH
Respiratory Department, Peking University Third Hospital, Peking University, Beijing, China.
Yao
Wan-Zhen
WZ
Gao
Jing-Zhen
JZ
Geng
Bin
B
Wang
Pei-Pei
PP
Tang
Chao-Shu
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D006862:Hydrogen Sulfide / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology*; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood; D012372:ROC Curve
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein; D006862:Hydrogen Sulfide