الفهرس 
SEPSISOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
Sepsis represents a global burden and is one of the leading causes of morbidity and mortality worldwide. Bacterial sepsis is associated with high economic burden and has a heavy impact on the patient, the healthcare system and the society.
Early diagnosis of bacterial sepsis is crucial but troublesome mainly due to difficulty in differentiating bacterial sepsis from other conditions with systemic inflammation. Blood culture is still used as a gold standard for diagnosing bacterial sepsis, but it has many shortcomings including the insufficient sensitivity and time-consuming procedure.
The use of biomarkers is a promising method for early diagnosis of sepsis, but an ideal biomarker has not yet been identified. Recently, DcR3 was identified as a possible sepsis biomarker, so it was chosen as a candidate for this study to assess its performance as a diagnostic biomarker of bacterial sepsis.
This study was performed in the ICUs at Ain Shams University Hospital, over a period from October 2018 to March 2019. Bacterial sepsis was diagnosed by positive blood culture or positive 16S rDNA PCR, while SIRS was identified by negative blood culture or negative 16S rDNA PCR results. Then, serum DcR3 level was measured in all patients and controls using quantitative ELISA. The ROC curve analysis was done for DcR3 and CRP, individually and in combination.
The serum DcR3 level was significantly higher in sepsis than SIRS patients and healthy controls (5.21 ± 2.28 ng/mL, 1.96 ± 0.90 ng/mL, and 0.95 ± 0.79 ng/mL, respectively). The ROC analysis showed that the AUC of DcR3 for sepsis versus SIRS was 0.920 at a cut-off >2.4 ng/mL, with 93.33% sensitivity and 86.67% specificity. The AUC of combined positive DcR3 and positive CRP for sepsis versus SIRS was 0.967 with 93.33% sensitivity and 100% specificity.
In conclusion, DcR3 is a promising biomarker for diagnosing bacterial sepsis. Moreover, using a combination of DcR3 and CRP shows an enhanced performance for diagnosing bacterial sepsis. Finally, DcR3 can help identifying sepsis patients, for whom the further use of expensive new diagnostic methods can be cost-effective.