Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Abstract

Background. Validating new sepsis biomarkers can contribute to early diagnosis and initiation of therapy. The aim of this study is to evaluate the sepsis predictive capacity of soluble urokinase plasminogen receptor (suPAR) and its role in evaluating the prognosis of bloodstream infections. Material and method. We conducted a prospective pilot study on 49 systemic inflammatory response syndrome (SIRS) patients admitted to the intensive care unit (ICU), that were divided, on the basis of bacteremia in group A (SIRS with bacteremia, n=14) and group B (SIRS without bacteremia, n=35). Hemoculture and blood samples were drawn on the first day to determine suPAR, C-reactive protein (CRP) and procalcitonin (PCT). We set to identify significant cut-off values in estimating bacteremia and mortality in septic patients. Results. In group A, suPAR values were 14.3 ng/mL (range 10-45.5 ng/mL) and in group B, 9.85 ng/mL (range 3.4-48 ng/mL) p=0.008. Area under the curve (AUC) for suPAR was 0.745 (95% CI: 0.600-0.859), for CRP 0.613 (95% CI: 0.522-0.799) and for PCT 0.718 (95% CI: 0.477-0.769). Cut-off value for suPAR in bacteremia prediction was 9.885 ng/mL, with 100% sensibility and 51.43% specificity. Mortality in group A was 85.7% (12/14) and in group B 74.3% (26/39), p>0.05. Area under the curve (AUC) for suPAR was 0.750 (95% CI: 0.455-0.936), for CRP 0.613 (95% CI: 0.413-0.913) and for PCT 0.618 (95% CI: 0.373-0.888). Cut-off value of suPAR in predicting mortality was 11.5 ng/mL, with 66.67% sensibility and 100% specificity. Conclusions. In our study suPAR had a predictive capacity for bacteremia and seems to be an independent factor for mortality prognosis in septic patients.

ROLE of suPAR and lactic acid in diagnosing sepsis and predicting mortality in elderly patients

“…The high sensitivity and specificity levels in this study at a relatively low cutoff value could be attributed to the fact that the control group was selected from healthy elders. Our findings support those of previously published researches, in which significantly higher levels of suPAR were found in patients with sepsis compared to non-septic patients [ 9 , 24 ] and in patients with blood culture-positive bacteremia compared to healthy controls [ 25 ], and showed a high predictive capacity for bacteremia in ICU patients [ 26 ]. It was also found to be significantly higher in critically ill patients compared to healthy controls [ 15 , 17 , 27 , 28 ].…”

Staphylococcal Scalded Skin Syndrome in Child. A Case Report and a Review from Literature

“…A study performed on septic patients underlined the fact that even though C-reactive protein and procalcitonin levels are not useful in diagnosing severe sepsis, they can be used in order to predict the fatal progression of this disorder [27]. Soluble urokinase-type plasminogen activator receptor (suPAR) is another important biomarker that seems have a predictive capacity for bacteremia in sepsis, even though it appears to be an independent factor for mortality prognosis in septic patients [28]. Another study, assessed the levels of Angiopoietin 2 and Tyrosine kinase 2 in septic patients and patients without sepsis, and concluded the fact that these two biomarkers had independent diagnostic value in septic patients [29].…”

A Fatal Case of Community Acquired Cupriavidus Pauculus Pneumonia

“…Sepsis biomarkers like angiopoietin 2, tyrosine kinase 2, procalcitonin, soluble urokinase-type plasmi-nogen receptor and CRP have been shown to be useful in the early diagnosis and prognosis in septic patients [13,14,15].…”