Plasma fibronectin as a marker of sepsis.

摘要

OBJECTIVES: To evaluate the value of plasma fibronectin (pFN) as a diagnostic marker of sepsis. SUBJECTS AND METHODS: Plasma FN was determined in patients showing sepsis-related symptoms who had blood cultures performed. These patients were assigned to one of two groups according to their clinical situation: (1) Clinical Septic Group: patients with sepsis according to American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) criteria; (2) Fever Peak Group: patients who did not fulfil sufficient ACCP/SCCM criteria for sepsis. Two additional control groups were also established: (3) Non-infectious Diseases Control Group and (4) Healthy Control Group. RESULTS: Plasma FN levels, microbiological and clinical data were compared among the different patient groups. For each group, the number of patients, median and mean pFN levels and the 95% confidence interval of the mean were: (1) n = 43, 102 mg/l, 122 mg/l (100-144); (2) n = 70, 185 mg/l, 207 mg/l (184-231); (3) n = 22, 175 mg/l, 181 mg/l (151-211); and (4) n = 22, 256 mg/l, 261 mg/l (229-292). Bonferroni's test of multiple comparisons was able to detect a significant difference between pFN concentrations corresponding to the septic group, compared to the remaining groups (pANOVA < 0.001 ). CONCLUSION: Plasma FN appears to act as a marker of sepsis in that patients showed diminished pFN levels. Along with other clinical and laboratory variables, the use of this marker would allow a rapid diagnosis of sepsis and limit the number of blood cultures to be processed and the number of antibiotic prescriptions, particularly when symptoms are insidious and diagnosis is doubtful. We propose further and more complex studies using a higher number of patients.