INCREASED SERUM CONCENTRATION OF SOLUBLE CD14 IS A PROGNOSTIC MARKER IN GRAM-POSITIVE SEPSIS

Increased serum sCD14 concentrations are associated with poor outcome in Gram-negative sepsis and trauma patients. In the present study seru m sCD14 concentrations were measured in patients with Grampositive sep sis and compared with Gram-negative septic and nonseptic intensive car e unit patients. Furthermore, serum sCD14 concentration was correlated with patient's outcome. Serum samples of 28 Grampositive (8 nonsurviv ors/20 survivors) and 10 Gramnegative bacteriemic patients (3 nonsurvi vors/7 survivors) were obtained at the day they met the sepsis criteri a defined by Bone et al. (Day 0) and at Days 4 and 7 and compared with 10 nonseptic ICU patients and 10 healthy volunteers. Serum concentrat ions of sCD14 were measured by ELISA. Significantly higher sCD14 serum concentrations were found on Days 4 and 7 in Gram-positive nonsurvivo rs than in Gram-positive survivors (Day 4: 5.85 +/- 0.48 vs 4.07 +/- 0 .43 mu g/ml, P < 0.05; Day 7: 6.12 +/- 0.46 vs 3.53 +/- 0.33 mu g/ml, P < 0.01). In addition, sCD14 concentrations of Gram-positive nonsurvi vors were significantly higher than those of nonseptic ICU patients an d healthy volunteers at any time of observation. However, no significa nt difference was calculated between Gram-positive and Gram-negative p atients. Summarizing our results, the serum level of sCD14 could be pr oven to be a good prognostic marker in the course of Gram-positive sep sis. Increased levels are associated with a high mortality. (C) 1996 A cademic Press, Inc.