Thrombin generation and mortality during Staphylococcus aureus sepsis

Sepsis-induced abnormalities of coagulation may contribute to mortality dur ing severe bacterial infection. The aim of this stud) was to examine change s in coagulation parameters and to assess the role of protein C supplementa tion during murine S. aureus sepsis. Gram-positive sepsis was characterized by a hypercoagulable state with predominant activation of the external coa gulation pathway, registered as an early increase of tissue factor activity and concomitant reduction in protein C. The internal coagulation pathway w as unaffected. No correlation between the changes of coagulation parameters and the intensity of inflammation, determined as serum IL-6 levels, was fo und. Supplementation with neither protein C or APC favoured survival in S. aureus sepsis. Reduction in thrombin generation in response to protein C su pplementation was associated with significantly increased survival. (C) 200 1 Academic Press.