[IL-6, IL-1β, and IL-10 levels in peripheral blood as indicators for early identification of gram-positive and gram-negative sepsis].

Objective To find out indicators for rapid identification of Gram-positive (G+) and Gram-negative (G-) bacteria through transcriptome sequencing of peripheral blood mononuclear cells (PBMCs) and serum liquid-phase chip technology in early sepsis. Methods 35 eligible cases out of 182 sepsis patients in the emergency intensive care unit (EICU) were selected for retrospective analysis. They were divided into G+ group (12 cases) and G- group (23 cases) based on their blood culture results. General characteristics like patients' age, gender, sequential organ failure assessment (SOFA) scores, etc. and other laboratory indexes such as blood routine, IL-6, CRP, procalcitonin(PCT)of these two groups were analyzed. PBMCs were isolated through single density gradient centrifugation. Total RNA was extracted for transcriptome sequencing to find out differential genes. Serum liquid-phase chip technology was performed to detect serum granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, monocytes chemotactic protein 1 (MCP-1), tumor necrosis factor alpha (TNF-α) in two groups. Receiver operating characteristic (ROC) curve was drawn using bacteria types as a dependent variable and selected cytokines as test variables, to analyze the correlation between selected biomarkers and bacteria type. Results No significant difference in general characteristics, CRP, and PCT were found between the G+ and G- group. The serum level of IL-6 in G+ group was lower than that in the G- group. Transcriptome sequencing results revealed 30 immune-related genes that were differentially expressed in the PBMCs of two groups. Compared to the G+ group, the serum levels of IL-6 and IL-1β in G- group significantly increased, while serum IL-10 was reduced. ROC curve analysis indicated that serum IL-6, IL-1β, and IL-10 levels could identify the G- and G+ bacteria types. The combined diagnosis using these three indicators is highly applicable in distinguishing G- and G+ bacteria. Conclusion IL-6, IL-1β and IL-10 levels can be used as indicators for early identification of sepsis induced by G+ or G- bacteria.