Delayed persistence of elevated monocytic MDSC associates with deleterious outcomes in septic shock: a retrospective cohort study

摘要

Increased %M-MDSC in septic shock patients. Representative gating strategy used to identify M-MDSC in whole blood from one healthy donor (control) and one patient (septic shock). M-MDSC (%) is the proportion of low HLA-DR monocytes among total CD14+ monocytes. M-MDSC in patients during the first week after septic shock onset (days 1–2,  = 259; days 3–4,  = 260; and days 6–8,  = 168). Patients’ main characteristics were as follows (% or median ± IQR): 67% male; age, 71 [63–79]; SAPS II at inclusion, 60 [49–73]; SOFA at D1, 9 [7–12]; Charlson, 2 [1–4]; and serum lactate at inclusion (mmol/L), 2.7 [1.8–4.4]. Main diagnosis categories were medical (49%)/surgical (51%), types of infection acquisition were community (55%)osocomial (45%), and the most frequent sites of infection were abdominal and pulmonary. Missing values corresponded to patients who died or left ICU before days 6–8 and to missing samples during the weekends for which staining was not possible since lab was not operating 24/7. Seventeen healthy donors served as controls (9 women and 8 men, median age was 49, range 28–62). Comparisons (each time point vs controls) based on Mann-Whitney test (**