Skip to main content

Advertisement

SpringerLink
Log in

Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study

  • Research
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes in leukocyte phenotype which would correlate with later development of sepsis.

Methods

Patients who were admitted in a tertiary ICU for organ support after severe injury (elective cardiac surgery, trauma, necessity of prolonged ventilation or stroke) were sampled on admission (T1) and 48–72 h later (T2) for phenotyping of leukocyte subsets by flow cytometry and cytokines measurements. Those who developed secondary sepsis or septic shock were sampled again on the day of sepsis diagnosis (Tx).

Results

Ninety-nine patients were included in the final analysis. Nineteen (19.2%) patients developed secondary sepsis or septic shock. They presented significantly higher absolute monocyte counts and CRP at T1 compared to non-septic patients (1030/µl versus 550/µl, p = 0.013 and 5.1 mg/ml versus 2.5 mg/ml, p = 0.046, respectively). They also presented elevated levels of monocytes with low expression of L-selectin (CD62Lneg monocytes) (OR[95%CI] 4.5 (1.4–14.5), p = 0.01) and higher SOFA score (p < 0.0001) at T1 and low mHLA-DR at T2 (OR[95%CI] 0.003 (0.00–0.17), p = 0.049). Stepwise logistic regression analysis showed that both monocyte markers and high SOFA score (> 8) were independently associated with nosocomial sepsis occurrence. No other leucocyte count or surface marker nor any cytokine measurement correlated with sepsis occurrence.

Conclusion

Monocyte counts and change of phenotype are associated with secondary sepsis occurrence in critically ill patients with injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and materials

The datasets used and/or analysed (beyond those included in the supplementary files) during the current study are available from the corresponding author on reasonable request.

Abbreviations

AUC:

Area under the curve

BSI:

Blood stream infection

CI:

Confidence interval

CLABSI:

Central line associated blood stream infection

CRP:

C-reactive protein

HAP:

Hospital-acquired pneumonia

HLA-DR:

Human leucocyte antigen

ICU:

Intensive care unit

IQR:

Interquartile range

LOS:

Length of stay

MFI:

Median fluorescence index or median of fluorescence intensity

OR:

Odds ratio

PE:

Phycoerythrin-linked

PerCP:

Perinidin-chlorophyll protein-linked

ROC:

Receiver operating characteristic

SOFA:

Sequential organ failure assessment

SSTI:

Surgical site and soft tissue infection

TNF-α:

Tumor necrosis factor α

VAP:

Ventilator-associated pneumonia

References

  1. Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, Finfer S, Pelosi P, Brazzi L, Aditianingsih D, et al. Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA. 2020;323:1478–87.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Markwart R, Saito H, Harder T, Tomczyk S, Cassini A, Fleischmann-Struzek C, Reichert F, Eckmanns T, Allegranzi B. Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis. Intensive Care Med. 2020;46:1536–51.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Vincent JL, Marshall JC, Namendys-Silva SA, Francois B, Martin-Loeches I, Lipman J, Reinhart K, Antonelli M, Pickkers P, Njimi H, et al. Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit. Lancet Respir Med. 2014;2:380–6.

    Article  PubMed  Google Scholar 

  4. Sakr Y, Jaschinski U, Wittebole X, Szakmany T, Lipman J, Namendys-Silva SA, Martin-Loeches I, Leone M, Lupu MN, Vincent JL, et al. Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit. Open Forum Infect Dis. 2018;5:ofy313.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gentile LF, Cuenca AG, Efron PA, Ang D, Bihorac A, McKinley BA, Moldawer LL, Moore FA. Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care. J Trauma Acute Care Surg. 2012;72:1491–501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kimura F, Shimizu H, Yoshidome H, Ohtsuka M, Miyazaki M. Immunosuppression following surgical and traumatic injury. Surg Today. 2010;40:793–808.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Angele MK, Chaudry IH. Surgical trauma and immunosuppression: pathophysiology and potential immunomodulatory approaches. Langenbecks Arch Surg. 2005;390:333–41.

    Article  PubMed  Google Scholar 

  8. Timmermans K, Kox M, Vaneker M, van den Berg M, John A, van Laarhoven A, van der Hoeven H, Scheffer GJ, Pickkers P. Plasma levels of danger-associated molecular patterns are associated with immune suppression in trauma patients. Intensive Care Med. 2016;42:551–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Slade MS, Simmons RL, Yunis E, Greenberg LJ. Immunodepression after major surgery in normal patients. Surgery. 1975;78:363–72.

    CAS  PubMed  Google Scholar 

  10. Munster AM, Eurenius K, Katz RM, Canales L, Foley FD, Mortensen RF. Cell-mediated immunity after thermal injury. Ann Surg. 1973;177:139–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Conway Morris A, Kefala K, Wilkinson TS, Dhaliwal K, Farrell L, Walsh T, Mackenzie SJ, Reid H, Davidson DJ, Haslett C, et al. C5a mediates peripheral blood neutrophil dysfunction in critically ill patients. Am J Respir Crit Care Med. 2009;180:19–28.

    Article  PubMed  Google Scholar 

  12. Meisel C, Schefold JC, Pschowski R, Baumann T, Hetzger K, Gregor J, Weber-Carstens S, Hasper D, Keh D, Zuckermann H, et al. Granulocyte-macrophage colony-stimulating factor to reverse sepsis-associated immunosuppression: a double-blind, randomized, placebo-controlled multicenter trial. Am J Respir Crit Care Med. 2009;180:640–8.

    Article  CAS  PubMed  Google Scholar 

  13. Venet F, Tissot S, Debard AL, Faudot C, Crampe C, Pachot A, Ayala A, Monneret G. Decreased monocyte human leukocyte antigen-DR expression after severe burn injury: correlation with severity and secondary septic shock. Crit Care Med. 2007;35:1910–7.

    Article  CAS  PubMed  Google Scholar 

  14. Venet F, Chung CS, Monneret G, Huang X, Horner B, Garber M, Ayala A. Regulatory T cell populations in sepsis and trauma. J Leukoc Biol. 2008;83:523–35.

    Article  CAS  PubMed  Google Scholar 

  15. Mannick JA, Rodrick ML, Lederer JA. The immunologic response to injury. J Am Coll Surg. 2001;193:237–44.

    Article  CAS  PubMed  Google Scholar 

  16. Ditschkowski M, Kreuzfelder E, Majetschak M, Obertacke U, Schade UF, Grosse-Wilde H. Reduced B cell HLA-DR expression and natural killer cell counts in patients prone to sepsis after injury. Eur J Surg. 1999;165:1129–33.

    Article  CAS  PubMed  Google Scholar 

  17. Livingston DH, Appel SH, Wellhausen SR, Sonnenfeld G, Polk HC Jr. Depressed interferon gamma production and monocyte HLA-DR expression after severe injury. Arch Surg. 1988;123:1309–12.

    Article  CAS  PubMed  Google Scholar 

  18. Asadullah K, Woiciechowsky C, Docke WD, Liebenthal C, Wauer H, Kox W, Volk HD, Vogel S, Von Baehr R. Immunodepression following neurosurgical procedures. Crit Care Med. 1995;23:1976–83.

    Article  CAS  PubMed  Google Scholar 

  19. Bidar F, Bodinier M, Venet F, Lukaszewicz AC, Brengel-Pesce K, Conti F, Quemeneur L, Leissner P, Tan LK, Textoris J, et al. Concomitant assessment of monocyte HLA-DR expression and ex vivo TNF-alpha release as markers of adverse outcome after various injuries-insights from the REALISM study. J Clin Med. 2021;11:96.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Gouel-Cheron A, Allaouchiche B, Guignant C, Davin F, Floccard B, Monneret G. Early interleukin-6 and slope of monocyte human leukocyte antigen-DR: a powerful association to predict the development of sepsis after major trauma. PLoS ONE. 2012;7: e33095.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Lukaszewicz AC, Grienay M, Resche-Rigon M, Pirracchio R, Faivre V, Boval B, Payen D. Monocytic HLA-DR expression in intensive care patients: interest for prognosis and secondary infection prediction. Crit Care Med. 2009;37:2746–52.

    CAS  PubMed  Google Scholar 

  22. Docke WD, Randow F, Syrbe U, Krausch D, Asadullah K, Reinke P, Volk HD, Kox W. Monocyte deactivation in septic patients: restoration by IFN-gamma treatment. Nat Med. 1997;3:678–81.

    Article  CAS  PubMed  Google Scholar 

  23. Polk HC Jr, Cheadle WG, Livingston DH, Rodriguez JL, Starko KM, Izu AE, Jaffe HS, Sonnenfeld G. A randomized prospective clinical trial to determine the efficacy of interferon-gamma in severely injured patients. Am J Surg. 1992;163:191–6.

    Article  PubMed  Google Scholar 

  24. Dries DJ, Jurkovich GJ, Maier RV, Clemmer TP, Struve SN, Weigelt JA, Stanford GG, Herr DL, Champion HR, Lewis FR, et al. Effect of interferon gamma on infection-related death in patients with severe injuries. A randomized, double-blind, placebo-controlled trial. Arch Surg. 1994;129:1031–41 (discussion 1042).

    Article  CAS  PubMed  Google Scholar 

  25. Conway Morris A, Datta D, Shankar-Hari M, Stephen J, Weir CJ, Rennie J, Antonelli J, Bateman A, Warner N, Judge K, et al. Cell-surface signatures of immune dysfunction risk-stratify critically ill patients: INFECT study. Intensive Care Med. 2018;44:627–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Guerin E, Orabona M, Raquil MA, Giraudeau B, Bellier R, Gibot S, Bene MC, Lacombe F, Droin N, Solary E, et al. Circulating immature granulocytes with T-cell killing functions predict sepsis deterioration*. Crit Care Med. 2014;42:2007–18.

    Article  CAS  PubMed  Google Scholar 

  27. Daix T, Guerin E, Tavernier E, Mercier E, Gissot V, Herault O, Mira JP, Dumas F, Chapuis N, Guitton C, et al. Multicentric standardized flow cytometry routine assessment of patients with sepsis to predict clinical worsening. Chest. 2018;154:617–27.

    Article  PubMed  Google Scholar 

  28. Venet F, Textoris J, Blein S, Rol ML, Bodinier M, Canard B, Cortez P, Meunier B, Tan LK, Tipple C, et al. Immune profiling demonstrates a common immune signature of delayed acquired immunodeficiency in patients with various etiologies of severe injury. Crit Care Med. 2022;50:565–75.

    Article  PubMed  Google Scholar 

  29. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707–10.

    Article  CAS  PubMed  Google Scholar 

  30. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315:801–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Boev C, Kiss E. Hospital-acquired infections: current trends and prevention. Crit Care Nurs Clin North Am. 2017;29:51–65.

    Article  PubMed  Google Scholar 

  32. Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O’Grady NP, Bartlett JG, Carratalà J, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases Society of America and the American thoracic society. Clin Infect Dis. 2016;63:e61–111.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Novosad SA, Fike L, Dudeck MA, Allen-Bridson K, Edwards JR, Edens C, Sinkowitz-Cochran R, Powell K, Kuhar D. Pathogens causing central-line-associated bloodstream infections in acute-care hospitals-United States, 2011–2017. Infect Control Hosp Epidemiol. 2020;41:313–9.

    Article  PubMed  Google Scholar 

  34. Mukherjee R, Kanti Barman P, Kumar Thatoi P, Tripathy R, Kumar Das B, Ravindran B. Non-classical monocytes display inflammatory features: validation in sepsis and systemic lupus erythematous. Sci Rep. 2015;5:13886.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Venet F, Guignant C, Monneret G. Flow cytometry developments and perspectives in clinical studies: examples in ICU patients. Methods Mol Biol. 2011;761:261–75.

    Article  CAS  PubMed  Google Scholar 

  36. Agnello L, Giglio RV, Bivona G, Scazzone C, Gambino CM, Iacona A, Ciaccio AM, Lo Sasso B, Ciaccio M. The value of a complete blood count (CBC) for sepsis diagnosis and prognosis. Diagnostics (Basel). 2021;11:1881.

    Article  CAS  PubMed  Google Scholar 

  37. Radzyukevich YV, Kosyakova NI, Prokhorenko IR. Participation of monocyte subpopulations in progression of experimental endotoxemia (EE) and systemic inflammation. J Immunol Res. 2021;2021:1762584.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Coiffard B, Diallo AB, Culver A, Mezouar S, Hammad E, Vigne C, Nicolino-Brunet C, Dignat-George F, Baumstarck K, Boucekine M, et al. Circadian rhythm disruption and sepsis in severe trauma patients. Shock. 2019;52:29–36.

    Article  CAS  PubMed  Google Scholar 

  39. Dong X, Wang C, Liu X, Bai X, Li Z. The trajectory of alterations in immune-cell counts in severe-trauma patients is related to the later occurrence of sepsis and mortality: retrospective study of 917 cases. Front Immunol. 2020;11: 603353.

    Article  CAS  PubMed  Google Scholar 

  40. Chung H, Lee JH, Jo YH, Hwang JE, Kim J. Circulating monocyte counts and its impact on outcomes in patients with severe sepsis including septic shock. Shock. 2019;51:423–9.

    Article  PubMed  Google Scholar 

  41. Aydin M, Barut S, Akbulut HH, Ucar S, Orman A. Application of flow cytometry in the early diagnosis of neonatal sepsis. Ann Clin Lab Sci. 2017;47:184–90.

    CAS  PubMed  Google Scholar 

  42. Buhrer C, Graulich J, Stibenz D, Dudenhausen JW, Obladen M. L-selectin is down-regulated in umbilical cord blood granulocytes and monocytes of newborn infants with acute bacterial infection. Pediatr Res. 1994;36:799–804.

    Article  CAS  PubMed  Google Scholar 

  43. Genel F, Atlihan F, Gulez N, Kazanci E, Vergin C, Terek DT, Yurdun OC. Evaluation of adhesion molecules CD64, CD11b and CD62L in neutrophils and monocytes of peripheral blood for early diagnosis of neonatal infection. World J Pediatr. 2012;8:72–5.

    Article  CAS  PubMed  Google Scholar 

  44. Griffin JD, Spertini O, Ernst TJ, Belvin MP, Levine HB, Kanakura Y, Tedder TF. Granulocyte-macrophage colony-stimulating factor and other cytokines regulate surface expression of the leukocyte adhesion molecule-1 on human neutrophils, monocytes, and their precursors. J Immunol. 1990;145:576–84.

    Article  CAS  PubMed  Google Scholar 

  45. Kishimoto TK, Jutila MA, Berg EL, Butcher EC. Neutrophil Mac-1 and MEL-14 adhesion proteins inversely regulated by chemotactic factors. Science. 1989;245:1238–41.

    Article  CAS  PubMed  Google Scholar 

  46. Spertini O, Luscinskas FW, Gimbrone MA Jr, Tedder TF. Monocyte attachment to activated human vascular endothelium in vitro is mediated by leukocyte adhesion molecule-1 (L-selectin) under nonstatic conditions. J Exp Med. 1992;175:1789–92.

    Article  CAS  PubMed  Google Scholar 

  47. Spertini O, Kansas GS, Munro JM, Griffin JD, Tedder TF. Regulation of leukocyte migration by activation of the leukocyte adhesion molecule-1 (LAM-1) selectin. Nature. 1991;349:691–4.

    Article  CAS  PubMed  Google Scholar 

  48. Holland J, Carey M, Hughes N, Sweeney K, Byrne PJ, Healy M, Ravi N, Reynolds JV. Intraoperative splanchnic hypoperfusion, increased intestinal permeability, down-regulation of monocyte class II major histocompatibility complex expression, exaggerated acute phase response, and sepsis. Am J Surg. 2005;190:393–400.

    Article  CAS  PubMed  Google Scholar 

  49. Cocks RA, Chan TY, Rainer TH. Leukocyte L-selectin is up-regulated after mechanical trauma in adults. J Trauma. 1998;45:1–6.

    Article  CAS  PubMed  Google Scholar 

  50. Briggs GD, Lemmert K, Lott NJ, de Malmanche T, Balogh ZJ. Biomarkers to guide the timing of surgery: neutrophil and monocyte L-selectin predict postoperative sepsis in orthopaedic trauma patients. J Clin Med. 2021;10:2207.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Rouget C, Girardot T, Textoris J, Monneret G, Rimmele T, Venet F. Biological markers of injury-induced immunosuppression. Minerva Anestesiol. 2017;83:302–14.

    Article  PubMed  Google Scholar 

  52. Huang LF, Yao YM, Dong N, Yu Y, He LX, Sheng ZY. Association between regulatory T cell activity and sepsis and outcome of severely burned patients: a prospective, observational study. Crit Care. 2010;14:R3.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Venet F, Chung CS, Kherouf H, Geeraert A, Malcus C, Poitevin F, Bohe J, Lepape A, Ayala A, Monneret G. Increased circulating regulatory T cells (CD4(+)CD25 (+)CD127 (-)) contribute to lymphocyte anergy in septic shock patients. Intensive Care Med. 2009;35:678–86.

    Article  PubMed  Google Scholar 

  54. Sebastian A, Sanju S, Jain P, Priya VV, Varma PK, Mony U. Non-classical monocytes and its potential in diagnosing sepsis post cardiac surgery. Int Immunopharmacol. 2021;99: 108037.

    Article  CAS  PubMed  Google Scholar 

  55. Matuschak GM. Circulating cytokine concentrations and outcome prediction in intensive care unit patients: still the tip of the iceberg? Crit Care Med. 1996;24:1769–71.

    Article  CAS  PubMed  Google Scholar 

  56. O’Dwyer MJ, Owen HC, Torrance HD. The perioperative immune response. Curr Opin Crit Care. 2015;21:336–42.

    Article  PubMed  Google Scholar 

  57. Cid J, Aguinaco R, Sanchez R, Garcia-Pardo G, Llorente A. Neutrophil CD64 expression as marker of bacterial infection: a systematic review and meta-analysis. J Infect. 2010;60:313–9.

    Article  PubMed  Google Scholar 

  58. Gamez-Diaz LY, Enriquez LE, Matute JD, Velasquez S, Gomez ID, Toro F, Ospina S, Bedoya V, Arango CM, Valencia ML, et al. Diagnostic accuracy of HMGB-1, sTREM-1, and CD64 as markers of sepsis in patients recently admitted to the emergency department. Acad Emerg Med. 2011;18:807–15.

    Article  PubMed  Google Scholar 

  59. Gros A, Roussel M, Sauvadet E, Gacouin A, Marque S, Chimot L, Lavoue S, Camus C, Fest T, Le Tulzo Y. The sensitivity of neutrophil CD64 expression as a biomarker of bacterial infection is low in critically ill patients. Intensive Care Med. 2012;38:445–52.

    Article  CAS  PubMed  Google Scholar 

  60. Icardi M, Erickson Y, Kilborn S, Stewart B, Grief B, Scharnweber G. CD64 index provides simple and predictive testing for detection and monitoring of sepsis and bacterial infection in hospital patients. J Clin Microbiol. 2009;47:3914–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Layios N, Lambermont B, Canivet JL, Morimont P, Preiser JC, Garweg C, Ledoux D, Frippiat F, Piret S, Giot JB, et al. Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients. Crit Care Med. 2012;40:2304–9.

    Article  CAS  PubMed  Google Scholar 

  62. Conway Morris A, Anderson N, Brittan M, Wilkinson TS, McAuley DF, Antonelli J, McCulloch C, Barr LC, Dhaliwal K, Jones RO, et al. Combined dysfunctions of immune cells predict nosocomial infection in critically ill patients. Br J Anaesth. 2013;111:778–87.

    Article  CAS  PubMed  Google Scholar 

  63. Bourgoin P, Taspinar R, Gossez M, Venet F, Delwarde B, Rimmele T, Morange PE, Malergue F, Monneret G. Toward monocyte HLA-DR bedside monitoring: a proof-of-concept study. Shock. 2021;55:782–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful for the insightful revision of Profs B. Misset and JM Cavaillon. We are thankful to BD Sciences for the generous gift of monoclonal antibodies.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Intensive Care, University Hospital of Liege, Domaine universitaire du Sart-Tilman, 4000, Liege, Belgium

    Nathalie Layios & Pierre Damas

  2. Laboratory of Cardiology, GIGA Institute, University Hospital of Liege, Liege, Belgium

    Nathalie Layios, Céline Delierneux & Cécile Oury

  3. Department of Hematobiology and Immuno-Hematology, University Hospital of Liege, Liege, Belgium

    Christian Gosset, Christelle Lecut & André Gothot

  4. Biostatistics and Research Method Center, University Hospital of Liege, Liege, Belgium

    Nathalie Maes

  5. Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liege, Liege, Belgium

    Alexandre Hego

  6. Department of Nephrology, University Hospital of Liege, Liege, Belgium

    Justine Huart

  7. Laboratory of Translational Research in Nephrology, GIGA, University Hospital of Liege, Liege, Belgium

    Justine Huart

Authors
  1. Nathalie Layios
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Gosset
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nathalie Maes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Céline Delierneux
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alexandre Hego
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Justine Huart
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christelle Lecut
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pierre Damas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cécile Oury
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. André Gothot
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NL, PD, CO and AG designed the study; NL, CG, CD, CL, AH and AG did the experiments; NL, CG, NM and AG analysed the data; NL wrote the manuscript, CG and AG revised the manuscript.

Corresponding author

Correspondence to Nathalie Layios.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Ethics approval and consent to participate

The study was appointed the Belgian number B707201111981 by the local ethics committee of University Hospital of Liège (number 707) and written informed consent was obtained from the patient or his/her legal representative.

Consent for publication

Not applicable.

Supplementary Information

Below is the link to the electronic supplementary material.

15010_2023_1983_MOESM1_ESM.jpg

Supplementary file1 Figure S1 (A-J) Flow cytometry gating strategy used to define lymphocyte, monocyte and granulocyte subsets by flow cytometry (explanation in the text). (JPG 246 KB)

15010_2023_1983_MOESM2_ESM.jpg

Supplementary file2 Figure S2 Panel A: Measurements at ICU admission in nonseptic and septic patients and in healthy controls (> 50 years). (*: p<0.05) (JPG 90 KB)

15010_2023_1983_MOESM3_ESM.jpg

Supplementary file3 Figure S2 Panel B: Predictive value of monocyte absolute count (/µl) obtained at T1. ROC curve analysis of sepsis occurrence based on levels of monocytes and of SOFA is shown. (JPG 109 KB)

15010_2023_1983_MOESM4_ESM.jpg

Supplementary file4 Figure S3 Absolute count of CD62Lneg monocytes (/µl): evolution of septic patients (N=12 patients with measurement at ICU admission, 48 to 72h later and on the day of sepsis diagnosis). (ns: not statistically significant). (JPG 86 KB)

15010_2023_1983_MOESM5_ESM.jpg

Supplementary file5 Figure S4 Intermediate monocytes (CD14++CD16+) median HLA-DR (MFI): evolution of septic patients (N=7 with measurement at ICU admission, 48 to 72h later and on the day of sepsis diagnosis). (ns: not statistically significant). (JPG 87 KB)

15010_2023_1983_MOESM6_ESM.docx

Supplementary file6 Table S1 Sites of infection and microbiological documentation. HAP-VAP: hospital-acquired pneumonia. VAP: ventilator-associated pneumonia. SSTI: surgical site and soft tissue infection. CLABSI: central line associated blood stream infection. BSI: primary blood stream infection. Some patients developed more than one infection and some infections were polymicrobial. Two episodes of VAP were clinically diagnosed and empirically treated although no organism grew in culture. (DOCX 17 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Layios, N., Gosset, C., Maes, N. et al. Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study. Infection 51, 1305–1317 (2023). https://doi.org/10.1007/s15010-023-01983-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-023-01983-3

Keywords

Search

Navigation