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Mannan-binding lectin and procalcitonin measurement for prediction of postoperative infection
Michael Siassi1, Jutta Riese, Rudi Steffensen
1Department of Surgery, University Hospital Erlangen, Erlangen, Germany. michael@siassi.de
Introduction:
Postoperative infection is a major cause of morbidity and mortality. We investigated two serum markers for their ability to identify patients at risk for postoperative infection. Mannan-binding lectin (MBL) is a central molecule of the innate immune system and MBL deficiency is known to predispose to infection. Procalcitonin (PCT) is a sensitive marker for bacterial infection.
Methods:
We investigated 162 patients undergoing elective surgery for cancer of the gastrointestinal tract. Patients were classified as having no complications (group A), having infection for unknown reason (group B) or having sepsis after events like aspiration or anastomotic leakage (group C). Analysis was done pre- and postoperatively for serum levels of MBL, PCT and C-reactive-protein. DNA was preoperatively sampled and stored and later analysed for genetic polymorphisms of MBL.
Results:
The preoperative serum levels of MBL were significantly lower in group B patients than in group A patients (1332 +/- 466 ng/ml versus 2523 +/- 181 ng/ml). PCT measured on day one post-surgery was significantly higher in group B patients than in group A (3.33 +/- 1.08 ng/ml versus 1.38 +/- 0.17 ng/ml). Patients with an aberrant MBL genotype had a significantly higher risk of postoperative infections than wild-type carriers (p < 0.05).
Conclusion:
Preoperative MBL and early postoperative PCT measurement may help identify patients at risk for postoperative infection.
Insights
Preoperative Mannan-binding lectin (MBL) levels and early postoperative Procalcitonin (PCT) can identify patients at risk for surgical site infections. MBL deficiency and specific genotypes increase infection susceptibility.
Area of Science:
- Immunology
- Surgical Oncology
- Clinical Chemistry
Background:
- Postoperative infection poses a significant threat to patient morbidity and mortality.
- Mannan-binding lectin (MBL) is crucial in innate immunity, and its deficiency is linked to increased infection risk.
- Procalcitonin (PCT) serves as a sensitive indicator for bacterial infections.
Purpose of the Study:
- To evaluate the efficacy of serum Mannan-binding lectin (MBL) and Procalcitonin (PCT) as predictive markers for postoperative infections.
- To investigate the association between MBL genetic polymorphisms and the risk of developing postoperative infections.
Main Methods:
- A cohort of 162 patients undergoing elective gastrointestinal cancer surgery was studied.
- Serum MBL, PCT, and C-reactive protein levels were analyzed pre- and postoperatively.
- Preoperative DNA analysis identified MBL genotypes, and patients were categorized based on postoperative complications.
Main Results:
- Significantly lower preoperative MBL levels were observed in patients who developed infections compared to controls.
- Early postoperative PCT levels were markedly elevated in infected patients.
- Patients with aberrant MBL genotypes exhibited a statistically significant higher risk of postoperative infections.
Conclusions:
- Preoperative MBL assessment can aid in identifying individuals predisposed to postoperative infections.
- Early postoperative PCT measurements are valuable for detecting infection risk in surgical patients.
- Combined MBL and PCT analysis may enhance the prediction of postoperative infectious complications.
