Beschreibung:
<jats:title>ABSTRACT</jats:title>
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<jats:title>Background:</jats:title>
<jats:p>In nonneutropenic intensive care unit (ICU) patients, current risk stratification scores lack specificity to reliably predict the risk of a prospective invasive candidiasis (IC). We aimed to explore possible associations of distinct immunological markers with different degrees of <jats:italic toggle="yes">Candida</jats:italic> affection in patients with abdominal sepsis.</jats:p>
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<jats:title>Methods:</jats:title>
<jats:p>The presented explorative, noninterventional diagnosis study recruited patients admitted to the surgical ICU at Heidelberg University Hospital with abdominal sepsis. Over 5 days, we determined white blood cell count, 1,3-β-<jats:sc>d</jats:sc>-glucan, and HLA-DR expression; the amount of Th1, Th17, regulatory T, T helper, and cytotoxic T cells; Dectin-1 and TLR2-expression; the amount of T, B, and NK cells; the <jats:italic toggle="yes">ex vivo</jats:italic> secretion of IL-8 upon stimulation with LPS, flagellin, and zymosan; and the distribution of distinct T-cell cytokines in a daily manner. On day 21, patients’ <jats:italic toggle="yes">Candida</jats:italic> infection status was stratified in no colonization or IC, colonization or IC.</jats:p>
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<jats:title>Results:</jats:title>
<jats:p>A total of 26 patients were included. On day 21, five patients showed no colonization or IC, in 13 patients a colonization was detected, and eight patients were diagnosed with IC. On study inclusion, the stratification groups showed comparable values in standard laboratory parameters and morbidity scores. Decreased B and NK cell counts, as well as reduced IL-8 secretion after <jats:italic toggle="yes">ex vivo</jats:italic> stimulation with LPS or flagellin seemed to be associated with a higher risk of subsequent <jats:italic toggle="yes">Candida</jats:italic> colonization. Even lower values could distinguish the therapy-relevant difference between prospective IC from colonization alone.</jats:p>
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<jats:title>Conclusions:</jats:title>
<jats:p>We were able to show distinct immune system impairments in early abdominal sepsis by specific immune-based measurements. A possible association of these impairments with a subsequent <jats:italic toggle="yes">Candida</jats:italic> affection is shown.</jats:p>
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