The impact of bacteremia on lipoprotein concentrations and patient's outcome: a retrospective analysis.

Eur J Clin Microbiol Infect Dis 2019 Jul 13;38(7):1279-1286. Epub 2019 Apr 13.

Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria.

Bacteremia is a major clinical challenge requiring early treatment. Metabolic alterations occur during bacteremia, and accordingly plasma concentrations of lipoproteins LDL-C and HDL-C are substantially changed. We questioned whether bacteremia with Gram-negative versus Gram-positive bacteria causes contrasting changes of lipoprotein levels in order to differentiate between the 2-g stain types and if there is a relation with outcome parameters namely ICU-admission, 30-day mortality, duration of hospitalization. This is a retrospective dual-center cross-sectional study, including 258 patients with bacteremia. Plasma lipid levels were analyzed within 48 h to positive blood culture. Upon admission, HDL-C, LDL-C, and total cholesterol (p = 0.99) in plasma did not significantly differ between patients with Gram-negative and Gram-positive bacteremia, while significantly higher triglyceride concentrations were found in Gram-negative bacteremia (p < 0.05). 30-day mortality and ICU admission were associated with lower LDL-C and HDL-C concentrations as compared to survivors and non-ICU patients, and patients with HDL-C < 20 mg dl and LDL-C < 55 mg dl had a relative risk (RR) of 2.85 for ICU therapy requirement and RR = 2 of death within 30 days. Reduced HDL-C and LDL-C concentrations were associated with adverse patient's outcome in bacteremia. Discrimination between Gram-negative and Gram-positive pathogens upon lipoprotein patterns is unlikely.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10096-019-03543-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570662PMC
July 2019

Publication Analysis

Top Keywords

bacteremia plasma
8
bacteremia
6
order differentiate
4
levels order
4
total cholesterol
4
ldl-c total
4
differentiate 2-g
4
admission hdl-c
4
stain types
4
hdl-c ldl-c
4
2-g stain
4
lipoprotein levels
4
changes lipoprotein
4
versus gram-positive
4
lipid levels
4
bacteremia gram-negative
4
questioned bacteremia
4
p = 099 plasma
4
gram-positive bacteria
4
contrasting changes
4

Similar Publications