Macrophage migration inhibitory factor is associated with positive cultures in patients with sepsis after cardiac surgery

• Published in: Shock (Augusta, Ga.) Vol. 24; no. 4; pp. 313 - 317
• Main Authors: FURTADO DE MENDONCA-FILHO, Hugo Tannus, SILVA GOMES, Gleice, MATTOS NOGUEIRA, Pedro Miguel, DE OLIVEIRA FERNANDES, Marco Aurelio, RANGEL TURA, Bernardo, SANTOS, Marisa, CASTRO-FARIA-NETO, Hugo Caire
• Format: Journal Article
• Language: English
• Published: Augusta, GA BioMedical Press 01-10-2005
• Subjects: Acute-Phase Reaction; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Infective Agents - pharmacology; Bacterial Infections - immunology; Bacterial Infections - microbiology; Biological and medical sciences; C-Reactive Protein - metabolism; Calcitonin - metabolism; Calcitonin Gene-Related Peptide; Cardiac Surgical Procedures - adverse effects; Chemokine CCL2 - metabolism; Cytokines - metabolism; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency and intensive care: infection, septic shock; Female; Humans; Inflammation; Intensive care medicine; Interleukin-10 - metabolism; Interleukin-6 - metabolism; Macrophage Migration-Inhibitory Factors - blood; Macrophage Migration-Inhibitory Factors - physiology; Male; Medical sciences; Middle Aged; Pilot Projects; Postoperative Complications; Protein Precursors - metabolism; ROC Curve; Sepsis - metabolism; Time Factors; Treatment Outcome; Tumor Necrosis Factor-alpha - metabolism; Human; microbiological screening; Intensive care; Cytokine; MIF; Medical screening; Infection; Sepsis syndrome; Surgery; Migration inhibitory factor; Sepsis; cardiac surgery; Resuscitation; Macrophage
• ISSN: 1073-2322
• DOI: 10.1097/01.shk.0000180622.52058.3a

This prospective consecutive observational study describes the blood levels of macrophage migration inhibitory factor (MIF), other cytokines, and markers of acute-phase response in 49 consecutive patients who developed the clinical syndrome of sepsis after cardiac surgery. Before starting antimicrobial treatment, all patients underwent microbiologic screening, and blood samples were collected. These samples subsequently were assayed for MIF, macrophage chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6 and -10, procalcitonin (PCT), and C-reactive protein (CRP). Patients with positive cultures (n = 25) had a higher mortality (P = 0.046) and higher levels of MIF (P < 0.001) than those with negative cultures (n = 24). We could not detect significant difference between the groups concerning the levels of CRP, PCT, IL6, IL10, MCP-1, or TNF-alpha. MIF levels showed an area under receiver operator curve of 0.823 for the prediction of culture-proven bacterial infection, with the best cut-off value at 988.5 pg/mL. In conclusion, circulating levels of MIF could be indicated as a valuable marker of microbiologically documented sepsis in patients after cardiac surgery, which suggests that MIF may be prospectively explored as a useful diagnostic tool in this setting.