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BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Use of plasma mitochondrial DNA levels for determining disease severity and prognosis in pediatric sepsis: a case control study

Authors: Hai peng Yan, Miao Li, Xiu lan Lu, Yi min Zhu, Wen-xian Ou-yang, Zheng hui Xiao, Jun Qiu, Shuang jie Li

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

The mortality rate due to severe sepsis is approximately 30–60%. Sepsis readily progresses to septic shock and multiple organ dysfunction, representing a significant problem in the pediatric intensive care unit (PICU). The aim of this study was to explore the value of plasma mitochondrial DNA (mtDNA) for early diagnosis and prognosis in children with sepsis.

Methods

A total of 123 children with sepsis who were hospitalized in the Hunan Children’s Hospital PICU from July 2013 to December 2014 were divided into the general sepsis group (n = 70) and severe sepsis group (n = 53) based on diagnostic standards. An additional 30 children with non-sepsis infection and 30 healthy children were randomly selected as a control group. Patients’ plasma was collected during admission to the PICU. A pediatric critical illness score (PCIS) was also calculated. The plasma mtDNA level was examined using real-time polymerase chain reaction technology, and other parameters including routine laboratory values; blood lactate, procalcitonin (PCT), and C-reactive protein (CRP) levels; and data on survival were collected and compared among the groups.

Results

The plasma mtDNA level in the sepsis group than that in the non-sepsis infection and healthy groups. The plasma mtDNA level was significantly higher in the severe sepsis than in the general sepsis group (p < 0.001). A lower PCIS was associated with a higher plasma mtDNA level (p < 0.001). A higher number of organs with dysfunction was associated with higher plasma mtDNA levels (p < 0.001). Plasma mtDNA levels were higher among patients with elevated alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, lactate dehydrogenase, creatine kinase, myoglobin, creatine kinase MB, and troponin than in those with values within the normal range. The mtDNA level was higher among non-survivors than among survivors, and this difference was significant. mtDNA showed a prognostic prediction value similar to that of lactate, PCT, and CRP.

Conclusions

Plasma mtDNA levels may be a suitable biomarker for diagnosis and prognosis in children with sepsis.
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Metadata
Title
Use of plasma mitochondrial DNA levels for determining disease severity and prognosis in pediatric sepsis: a case control study
Authors
Hai peng Yan
Miao Li
Xiu lan Lu
Yi min Zhu
Wen-xian Ou-yang
Zheng hui Xiao
Jun Qiu
Shuang jie Li
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1239-z

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