Soluble adhesion molecules, cytokines and cellular markers in serum in patients with acute infections

The aim of this study aas to evaluate the diagnostic capacity of a number o f blood components such as soluble adhesion molecules, interleulin-6 (L-6), myeloperoxidase (MPO) and lysozyme in the distinction of acute bacterial a nd viral infections. Blood was taken from 115 acutely infected patients at admission before any treatment and in some cases on several consecutive day s, 35 of the patients had a definite viral cause for their infection and 66 a bacterial cause. All variables were raised in patients Kith acute bacter ial infections. Soluble vascular cell adhesion molecule-1 (sVCAM-1), sE-sel ectin, lysozyme and MPO were also raised in acute viral infections, but for sE-selectin end MPO less so than in bacterial infections. Evaluation of th e diagnostic power showed that for MPO and IL-6 at cut-offs of 1300 mug/l a nd 10 ng/l. respectively, the positive predictive value was 97% and 100% an d the negative predictive value 78% and 76%, respectively, in the classific ation of acute bacterial infections. In the distinction between viral or ba cterial causes of acute infections in otherwise healthy subjects serum meas urements of MPO and IL-6 are valuable tools and should be considered as dia gnostic aids in the routine setting. The soluble adhesion molecules did not offer any further information in this respect.