Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients

• Published in: Scientific reports 2018-08, Vol.8 (1), p.11999-9, Article 11999
• Main Authors: Almansa, Raquel, Martín, Silvia, Martin-Fernandez, Marta, Heredia-Rodríguez, María, Gómez-Sánchez, Esther, Aragón, Marta, Andrés, Cristina, Calvo, Dolores, Rico-Feijoo, Jesus, Esteban-Velasco, Maria Carmen, Vaquero-Roncero, Luis Mario, Ortega, Alicia, Gómez-Pesquera, Estefania, Lorenzo-López, Mario, de Cenarruzabeitia, Iñigo López, Benavides, Diana, López-Sanchez, Jaime, Doncel, Cristina, González-Sanchez, Carmen, Zarca, Esther, Ríos-Llorente, Alberto, Diaz, Agustín, Sanchez-Barrado, Elisa, de Heredia, Juan Beltran, Calvo-Vecino, Jose Maria, Muñoz-Bellvís, Luis, Gomez-Herreras, Jose Ignacio, Aldecoa, César, Tamayo, Eduardo, Bermejo-Martin, Jesus F.
• Format: Article
• Language: English
• Subjects: 38; 38/39; 38/77; 631/337/2019; 692/308/53; Gene expression; Histocompatibility antigen HLA; Humanities and Social Sciences; Inflammation; multidisciplinary; Multivariate analysis; Procalcitonin; Science; Science (multidisciplinary); Sepsis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-018-30505-7

Early recognition of sepsis is a key factor to improve survival to this disease in surgical patients, since it allows prompt control of the infectious source. Combining pro-inflammatory and immunosupression biomarkers could represent a good strategy to improve sepsis detection. Here we evaluated the combination of procalcitonin (PCT) with gene expression levels of HLA-DRA to detect sepsis in a cohort of 154 surgical patients (101 with sepsis and 53 with no infection). HLA-DRA expression was quantified using droplet digital PCR, a next-generation PCR technology. Area under the receiver operating curve analysis (AUROC) showed that the PCT/HLA-DRA ratio outperformed PCT to detect sepsis (AUROC [CI95%], p ): PCT: 0.80 [0.73–0.88],