ABSTRACT
Objective: Although several biomarkers have been evaluated for the diagnosis and prognosis of sepsis, the gold standard biomarker has not yet been found. We aimed to evaluate the diagnostic value of neutrophilto- lymphocyte count ratio [NLCR], neopterin, pro-adrenomedullin [pro-ADM] and the other infection markers to predict bacteremia in patients with SIRS, sepsis and severe sepsis/septic shock
Methods: A prospective cohort study was conducted on septic patients in a tertiary referral hospital between December 2014- July 2015. A total of 156 patients diagnosed with SIRS, sepsis and severe sepsis/ septic shock in Anesthesia intensive care unit [ICU] were included in the study
Results: A total of 156 patients who had been diagnosed as SIRS[10.9%], sepsis [44.2%] and severe sepsis/septic shock [44.9%] were included. Positive blood cultures were obtained in 64 patients. NLCR, neopterin and pro-ADM levels were insignificant in predicting bacteremia [p>0.05]. The mortality rate was significantly higher in bacteremic sepsis [43.9%] compared to non-bacteremic patients [20.8%] [p=0.001]. Only procalcitonin levels were significant predictor of mortality [p<0.001]
Conclusion: NLCR, CRP, procalcitonin, neopterin and pro-ADM levels were insignificant in diagnosis of bacteremia in critically ill patients. The gold standard method in predicting bacteremia is still blood culture positivity
ABSTRACT
BACKGROUND/AIMS: The aims of the present study were to determine the outcomes of inactive hepatitis B virus (HBV) surface antigen (HBsAg) carriers over a 10-year study period and to elucidate the HBV serological profile of their family members. METHODS: We retrospectively analyzed the medical files of inactive HBsAg carriers followed up at the Department of Infectious Diseases of Kocatepe University Medical Faculty Hospital between March 2001 and January 2011. RESULTS: In total, 438 inactive HBsAg carriers were enrolled in this trial. The follow-up period was 33.7+/-22.5 months (mean+/-SD). Anti-hepatitis-B surface antibody seroconversion occurred in 0.7% of cases, while chronic hepatitis B was found in 0.5%. The anti-hepatitis-D virus (HDV) status was evaluated in 400 patients and anti-hepatitis C virus (HCV) in 430. It was found that 1% and 0.2% were positive for anti-HDV and anti-HCV, respectively. HBV serology was investigated in at least 1 family member of 334/438 (76.3%) patients. The HBsAg positivity rate was 34.6% in 625 family members of 334 patients. A comparison of the HBsAg positivity rates in terms of HBV DNA levels in index cases revealed that HBsAg seropositivity rates were higher in family members of HBV DNA-negative patients than in family members of HBV DNA-positive cases (P=0.0001). CONCLUSIONS: The HBsAg positivity rate was higher in family members of inactive HBsAg carriers than in the general population; these family members therefore have a higher risk of HBV transmission. Furthermore, despite negative HBV DNA levels, transmission risk was not reduced in these patients, and horizontal transmission seems to be independent of the HBV DNA value.