| Autor: |
Mosevoll KA; Section for Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.; Section for Infectious Diseases, Department of Clinical Research, University of Bergen, 5021 Bergen, Norway., Hansen BA; Department of Medicine, Central Hospital for Sogn and Fjordane, 6812 Førde, Norway., Gundersen IM; Section for Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.; Section for Infectious Diseases, Department of Clinical Research, University of Bergen, 5021 Bergen, Norway., Reikvam H; Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.; Leukemia Research Group, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway., Bruserud Ø; Department for Anesthesiology and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway., Bruserud Ø; Section for Hematology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.; Leukemia Research Group, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway., Wendelbo Ø; Section for Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway.; Faculty of Health, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway. |
| Abstrakt: |
Sepsis is a dysregulated host response to infection that causes potentially life-threatening organ dysfunction. We investigated the serum metabolomic profile at hospital admission for patients with bacterial sepsis. The study included 60 patients; 35 patients fulfilled the most recent 2016 Sepsis-3 criteria whereas the remaining 25 patients only fulfilled the previous Sepsis-2 criteria and could therefore be classified as having systemic inflammatory response syndrome (SIRS). A total of 1011 identified metabolites were detected in our serum samples. Ninety-seven metabolites differed significantly when comparing Sepsis-3 and Sepsis-2/SIRS patients; 40 of these metabolites constituted a heterogeneous group of amino acid metabolites/peptides. When comparing patients with and without bacteremia, we identified 51 metabolites that differed significantly, including 16 lipid metabolites and 11 amino acid metabolites. Furthermore, 42 metabolites showed a highly significant association with the maximal total Sequential Organ Failure Assessment (SOFA )score during the course of the disease (i.e., Pearson's correlation test, p -value < 0.005, and correlation factor > 0.6); these top-ranked metabolites included 23 amino acid metabolites and a subset of pregnenolone/progestin metabolites. Unsupervised hierarchical clustering analyses based on all 42 top-ranked SOFA correlated metabolites or the subset of 23 top-ranked amino acid metabolites showed that most Sepsis-3 patients differed from Sepsis-2/SIRS patients in their systemic metabolic profile at the time of hospital admission. However, a minority of Sepsis-3 patients showed similarities with the Sepsis-2/SIRS metabolic profile even though several of them showed a high total SOFA score. To conclude, Sepsis-3 patients are heterogeneous with regard to their metabolic profile at the time of hospitalization. |
