Association of Pulmonary Pathogenic Microbial Load and Cytokine Levels with Sepsis Mortality: A Cross- Sectional Study

Abstract

Background Sepsis, a severe systemic inflammatory response resulting from an infection, often culminates in high mortality rates. Cytokines, specifically IL-10, and pathogenic microbial load, play a pivotal role in its pathogenesis. IL-10's integral role in immune regulation potentially impacts the clearance of pathogenic microorganisms and the disease's severity. However, the correlation between IL-10 levels, pulmonary pathogenic microbial load in sepsis, and their subsequent impact on patient prognosis remain unclear. Therefore, this study aims to elucidate the association between IL-10 levels, lung pathogenic microbial load, and their impact on the prognosis of sepsis. Methods We gathered clinical data from 79 patients with sepsis, including age, gender, BMI, history of chronic diseases, laboratory test results, cytokine levels, and mNGS analysis results. Univariate analysis and multivariate linear regression were utilized to examine the relationship between each variable and the pathogenicic microbial load in bronchoalveolar lavage fluid, as determined by mNGS. To further study the prognosis, patients were categorized based on the quantity of pathogenic microbes, and survival analysis was conducted using the Kaplan-Meier method. Results The study identified a significant positive correlation between cytokine IL-10 levels and the quantity of pathogenic microbes (β: 0.018,95%CI: 0.014 ~ 0.021,P value < 0.001). Multivariate linear regression analysis further confirmed this positive correlation (β:0.01,95%CI: 0.01 ~ 0.02,P value < 0.001), which held stable after adjusting for all potential confounders. Furthermore, Kaplan-Meier survival analysis revealed a significant increase in the 28-day mortality rate for sepsis patients when the count of pathogenic microbes reached or exceeded three. Conclusion Our study discloses the correlation between IL-10 levels and pathogenic microbial load, and their substantial predictive value for the short-term survival of sepsis patients. These findings highlight the critical importance of meticulous monitoring and managing of IL-10 levels and pathogenic microbial load in clinical practice. Timely intervention measures are particularly imperative for sepsis patients exhibiting both high IL-10 levels and pathogenic microbial load. These results provide fresh insights and understanding that can potentially enhance the clinical treatment and prognosis of sepsis.