title: Genetic polymorphism in postoperative sepsis after open heart surgery in infants.
abstract: BACKGROUND
  Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis.
  
  
  METHODS
  A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score ≥6. Patients with an accompanying congenital anomaly, human immunodeficiency virus infection, or history of previous open heart surgery were excluded. The patients' nutritional status and genetic polymorphism were assessed prior to surgery. The results of genetic polymorphism were obtained through genotyping. Patients' ages on the day of surgery and cardiopulmonary bypass times were recorded. The diagnosis of sepsis was established according to Surviving Sepsis Campaign criteria.
  
  
  RESULTS
  Postoperative sepsis was observed in 21% of patients. There were 92.6% patients with toll-like receptor 2 N199N polymorphism and 52.8% with toll-interacting protein rs5743867 polymorphism.
  
  
  CONCLUSIONS
  Toll-like receptor 2 N199N polymorphism tends to increase the risk of sepsis (odds ratio = 1.974; 95% confidence interval: 0.23-16.92; p = 0.504), while toll-interacting protein rs5743867 polymorphism tends to decrease the risk of sepsis (odds ratio = 0.496; 95% confidence interval: 0.19-1.27; p = 0.139) in infants <1-year old undergoing complex open heart surgery.
authors.affiliation: Pediatric and Congenital Heart Surgery Unit, Department of Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia difawi@yahoo.com.
authors.forename: Dicky
authors.initials: D
authors.lastname: Fakhri
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Samsuridjal
authors.initials: S
authors.lastname: Djauzi
authors.affiliation: Cardiothoracic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Tri Wahyu
authors.initials: TW
authors.lastname: Murni
authors.affiliation: Thoracic and Cardiovascular Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Jusuf
authors.initials: J
authors.lastname: Rachmat
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Alida Roswita
authors.initials: AR
authors.lastname: Harahap
authors.affiliation: Pediatric Cardiology Division, Department of Pediatrics, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Sri Endah
authors.initials: SE
authors.lastname: Rahayuningsih
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
authors.forename: Muchtaruddin
authors.initials: M
authors.lastname: Mansyur
authors.affiliation: Research and Development Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
authors.forename: Anwar
authors.initials: A
authors.lastname: Santoso
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D047908:Intracellular Signaling Peptides and Proteins / Q000235:genetics*; D008297:Male; D016017:Odds Ratio; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology; D051195:Toll-Like Receptor 2 / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D047908:Intracellular Signaling Peptides and Proteins; C495342:TLR2 protein, human; C410602:TOLLIP protein, human; D051195:Toll-Like Receptor 2
keywords: Genetic predisposition to disease; Immune system; Infant; Sepsis; TOLLIP protein; Toll-like receptor 2; human