Biomarker could be objective and reliable tools to predict mortality in sepsis. We explored the prognostic utilities of emerging biomarkers in septic patients and questioned whether adding biomarkers to the clinical variables would improve the prediction of mortality in sepsis. This retrospective study included 157 septic patients (112 patients with sepsis; 45 patients with septic shock). Procalcitonin (PCT), presepsin, galectin-3, and soluble suppression of tumorigenicity 2 (sST2) concentrations were analyzed in relation to the 30-day all-cause mortality. Their value added on top of Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score, high-sensitivity C-reactive protein, and white blood cells was also analyzed. PCT could not predict 30-day mortality. Univariate hazard ratio [HR with 95% confidence interval (CI)] of the other dichotomized variables was: 1.33 (0.55–3.194) for presepsin; 7.87 (2.29–26.96) for galectin-3; 1.55 (0.71–3.38) for sST2; and 2.18 (1.01–4.75) for SOFA score. The risk of 30-day mortality increased stepwise as the number of biomarkers above optimal cutoff values increased, and the highest risk was observed when all four biomarkers and SOFA score increased (HR = 14.5). Multi-marker approach predicted 30-day mortality better than SOFA score [area under the curves (95% CI), 0.769 (0.695–0.833) vs. 0.615 (0.535–0.692)]. In reclassification analyses, adding biomarkers to clinical variables improved the prediction of mortality. This study demonstrated a possible prognostic utility of PCT, presepsin, galectin-3, and sST2 in sepsis. Multi-marker approach could be beneficial for an optimized management of patients with sepsis.

Data concerning the human microbiota composition during Clostridioides (Clostridium) difficile infection (CDI) using next-generation sequencing are still limited. We aimed to confirm key features indicating tcdB positive patients and compare the microbiota composition between subgroups based on toxin gene load (tcdB gene) and presence of significant diarrhea. Ninety-nine fecal samples from 79 tcdB positive patients and 20 controls were analyzed using 16S rRNA gene sequencing. Chao1 index for alpha diversity were calculated and principal coordinate analysis was performed for beta diversity using Quantitative Insights into Microbial Ecology (QIIME) pipeline. The mean relative abundance in each group was compared at phylum, family, and genus levels. There were significant alterations in alpha and beta diversity in tcdB positive patients (both colonizer and CDI) compared with those in the control. The mean Chao1 index of tcdB positive patients was significantly lower than the control group (P<0.001), whereas there was no significant difference between tcdB groups and between colonizer and CDI. There were significant differences in microbiota compositions between tcdB positive patients and the control at phylum, family, and genus levels. Several genera such as Phascolarctobacterium, Lachnospira, Butyricimonas, Catenibacterium, Paraprevotella, Odoribacter, and Anaerostipes were not detected in most CDI cases. We identified several changes in the microbiota of CDI that could be further evaluated as predictive markers. Microbiota differences between clinical subgroups of CDI need to be further studied in larger controlled studies.

Chung HJ, et al. Ann Lab Med. 2020 Jan;40(1):72-75. https://doi.org/10.3343/alm.2020.40.1.72

Park DC, et al. Ann Lab Med. 2019 Nov;39(6):537-544. https://doi.org/10.3343/alm.2019.39.6.537

Helicobacter pylori infection is endemic in Korea, and serology testing is widely performed. The aim of this study was to validate and compare the diagnostic accuracy of Korean and Western serologic assays for H. pylori detection in Korean adults. The 114 Korean adults who visited our center over a 6-month period for the evaluation of H. pylori infection using the urea breath test (UBT) were enrolled in this prospective study. Anti-H. pylori IgG was measured using three commercially available immunoassays: Genedia H. pylori ELISA (Green Cross Medical Science Co., Eumseong, Korea), Chorus helicobacter IgG (DIESSE Diagnostica Senese, Siena, Italy), and Vidas H. pylori IgG (BioMérieux, Marcy-l'Etoile, France). Positive UBT findings were obtained in 40.6% of included subjects. The sensitivities and the specificities of Vidas, Chorus and Genedia were 89.7%, 100% and 100% and 85.5%, 75.4% and 80.7%, respectively. We found no differences in sensitivity between the Vidas and Chorus (p=0.125), Chorus and Genedia (p=0.125), and Vidas and Genedia (p=1.000) assays. There were also no differences in specificity between the Vidas and Chorus (p=0.070), Chorus and Genedia (p=0.508), and Vidas and Genedia (p=0.549) assays.In Korean adults, the Genedia H. pylori ELISA, Chorus helicobacter IgG, and Vidas H. pylori IgG assays exhibited a high concurrence rate with similar diagnostic accuracy. Thus, both the Korean and Western noninvasive assays are reliable for serodiagnosis of H. pylori in Korean individuals.