Activated platelet-derived microparticle numbers are elevated in patients with severe fungal (Candida albicans) sepsis

Background The treatment of severe sepsis highly depends on the identification of bacteria or fungi from blood and/or other body materials. Although widely available blood culturing and risk assessment scores are not completely reliable, current guidelines do not recommend the wide empirical use of...

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Published in:Annals of clinical biochemistry 2012-11, Vol.49 (6), p.554-560
Main Authors: Woth, Gábor, Tőkés-Füzesi, Margit, Magyarlaki, Tamás, Kovács, Gábor L, Vermes, István, Mühl, Diana
Format: Article
Language:English
Subjects:
Aged
Annexin A5 - metabolism
Blood Platelets - cytology
Blood Platelets - pathology
Candida albicans
Candida albicans - physiology
Candidiasis - blood
Candidiasis - pathology
Cell-Derived Microparticles - chemistry
Cell-Derived Microparticles - pathology
Clinical Laboratory Techniques - methods
Clinical Laboratory Techniques - standards
Female
Flow Cytometry
Humans
Male
Middle Aged
Multiple Organ Failure - pathology
Platelet Membrane Glycoprotein IIb - metabolism
Prospective Studies
Sepsis - blood
Sepsis - pathology
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Summary:Background The treatment of severe sepsis highly depends on the identification of bacteria or fungi from blood and/or other body materials. Although widely available blood culturing and risk assessment scores are not completely reliable, current guidelines do not recommend the wide empirical use of antifungal medications based on questionable benefit or possible side-effects. We aimed to test whether platelet-derived microparticle (MP) measurements can improve the early detection of the infective agent behind sepsis. Methods Thirty-three consecutive severe septic patients from our university intensive care unit were included in our prospective study. MP number and surface antigen characteristics were followed by flow cytometry on days 1 (admission), 3 and 5. For microbiological identification, various specimens were collected on admission and in case of overall status deterioration. Results On admission, septic patients showed elevated annexin V and constitutive platelet marker (CD41)-positive MP numbers compared with volunteers. Mixed fungal septic patients showed significantly elevated annexin V and CD41-positive particle numbers on day 1 (P < 0.05) compared with the non-fungal septic group. Adhesive platelet marker (CD42a) harbouring vesicles were negligible in the non-fungal group, while fungal septic patients showed significantly elevated numbers in all measurements (P < 0.01). Particles from activated platelets (PAC1) had elevated numbers in the first and fifth study days compared with non-fungal septic patients (P < 0.05). Conclusions The measurement of CD42a- and PAC1-positive microparticles may provide important additional information which can help to improve the early instalment of antifungal therapy of severe septic patients.
ISSN:0004-5632
1758-1001
DOI:10.1258/acb.2012.011215