Early biomarkers of sepsis in post-burn patients identified

A test has been devised that might allow clinicians to predict whether a burn patient will develop sepsis post-injury, reported researchers from the University of Birmingham in Birmingham, England.

Their findings, published online in Annals of Surgery (May 26, 2016), show that using just three biomarkers of neutrophil function on the day of burn injury can determine which patients with severe burns are likely to become septic.

During the study, the researchers evaluated 63 patients with severe burns covering >=15% total of their body surface area. The authors indicated that neutrophil phagocytosis, oxidative burst capacity, and neutrophil extracellular trap (NET) generation (NETosis) were measured from day one to up to one year post-burn injury.

Additionally, the authors noted that immature granulocyte (IG) count, plasma cell free DNA (cfDNA), and plasma citrullinated histone H3 (Cit H3) levels were also measured.

Early biomarkers of sepsis identified

The findings suggested that neutrophil dysfunction, IG count and cfDNA are potential early biomarkers for the prediction or early diagnosis of sepsis post-burn injury.

“Our data showed that IG count could accurately discriminate between septic and non-septic patients, even with the complications that systemic inflammatory response syndrome has caused for other potential biomarkers,” said Professor Janet Lord, PhD, director of the University of Birmingham’s Institute of Inflammation and Ageing, who was quoted in a press release.

“In addition to this, when we used a combination of two or more of our biomarkers, the discriminatory power was further enhanced,” said Prof. Lord, who jointly lead the study.

Major burn injuries result in a systemic inflammatory response syndrome (SIRS) and reduced immune function, which increases the risk of patients developing sepsis or infections in hospitals, she added.

“A delay in diagnosis of sepsis of only a few hours leads to a rapid increase in risk of death. The administration of antibiotics within three hours after sepsis recognition is recommended, but only when positive blood cultures are present,” said Prof. Lord.

“However, that the majority of clinical studies report negative cultures in as many as 40 per cent of severe sepsis patients—so many cases will be missed. As such, the identification of novel, accurate biomarkers is crucial.”

The team plan to further their research by carrying out a trial in post-burn patients to see if the use of this new test will help to reduce the incidence of sepsis by allowing doctors to give antibiotics to patients promptly.


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