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01-07-2018 | Original

Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study

Authors: Marianna Parlato, François Philippart, Alexandra Rouquette, Virginie Moucadel, Virginie Puchois, Sophie Blein, Jean-Pierre Bedos, Jean-Luc Diehl, Olfa Hamzaoui, Djillali Annane, Didier Journois, Myriam Ben Boutieb, Laurent Estève, Catherine Fitting, Jean-Marc Treluyer, Alexandre Pachot, Minou Adib-Conquy, Jean-Marc Cavaillon, Benoît Misset, The Captain Study Group

Published in: Intensive Care Medicine | Issue 7/2018

Abstract

Purpose

Sepsis and non-septic systemic inflammatory response syndrome (SIRS) are the same syndromes, differing by their cause, sepsis being secondary to microbial infection. Microbiological tests are not enough to detect infection early. While more than 50 biomarkers have been proposed to detect infection, none have been repeatedly validated.

Aim

To assess the accuracy of circulating biomarkers to discriminate between sepsis and non-septic SIRS.

Methods

The CAPTAIN study was a prospective observational multicenter cohort of 279 ICU patients with hypo- or hyperthermia and criteria of SIRS, included at the time the attending physician considered antimicrobial therapy. Investigators collected blood at inclusion to measure 29 plasma compounds and ten whole blood RNAs, and—for those patients included within working hours—14 leukocyte surface markers. Patients were classified as having sepsis or non-septic SIRS blindly to the biomarkers results. We used the LASSO method as the technique of multivariate analysis, because of the large number of biomarkers.

Results

During the study period, 363 patients with SIRS were screened, 84 having exclusion criteria. Ninety-one patients were classified as having non-septic SIRS and 188 as having sepsis. Eight biomarkers had an area under the receiver operating curve (ROC-AUC) over 0.6 with a 95% confidence interval over 0.5. LASSO regression identified CRP and HLA-DRA mRNA as being repeatedly associated with sepsis, and no model performed better than CRP alone (ROC-AUC 0.76 [0.68–0.84]).

Conclusions

The circulating biomarkers tested were found to discriminate poorly between sepsis and non-septic SIRS, and no combination performed better than CRP alone.

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Title: Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study
Authors: Marianna Parlato
François Philippart
Alexandra Rouquette
Virginie Moucadel
Virginie Puchois
Sophie Blein
Jean-Pierre Bedos
Jean-Luc Diehl
Olfa Hamzaoui
Djillali Annane
Didier Journois
Myriam Ben Boutieb
Laurent Estève
Catherine Fitting
Jean-Marc Treluyer
Alexandre Pachot
Minou Adib-Conquy
Jean-Marc Cavaillon
Benoît Misset
The Captain Study Group
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 7/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5228-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study

Abstract

Purpose

Aim

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Aim

Methods

Results

Conclusions

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