Table 1.
Patients characteristics
| No secondary infection (n = 17) | Secondary infection (n = 12) | p value | |
|---|---|---|---|
| Age (years) | 52 (47–54) | 64 (62–66) | 0.005 |
| BMI (kg/m2) | 28.5 (26.3–31.4) | 29.3 (27.4–33) | 0.44 |
| Gender male | 10 (58.8) | 10 (83.3) | 0.16 |
| SOFA score | |||
| Day 1 | 7 (4–11) | 10 (7–14) | 0.095 |
| Day 3 | 7 (4–10) | 11 (7–14.5) | 0.024 |
| Day 7 | 6 (4.5–7) | 11 (8–14.5) | 0.013 |
| Day 10 | 3 (3–6) | 11 (9–13.5) | 0.02 |
| SAPS II score | |||
| Day 1 | 45 (27–58) | 59 (54–67) | 0.03 |
| Day 3 | 48 (24–55) | 62 (58–64) | 0.04 |
| Day 7 | 40 (25–49) | 60(58–69) | 0.02 |
| Day 10 | 23 (13–35) | 65 (56–70) | 0.001 |
| Comorbidities | |||
| Cardiologic | 5 (29.4) | 10 (83.3) | 0.004 |
| Hypertension | 5 (100) | 9 (90) | – |
| Hypertrophic cardiomyopathy | 1 (20) | 0 | – |
| Peripheral artery occlusive disease | 1 (20) | 1 (10) | – |
| Ischemic cardiopathy | 0 | 2 (20) | – |
| Pneumologic | 2 (11.8) | 1(8.3) | 0.77 |
| Neurologic | 2 (11.8) | 3 (25) | 0.35 |
| Immunologic | 3 (17.6) | 1 (8.3) | 0.47 |
| Metabolic | 7 (41.2) | 8 (66.7) | 0.18 |
| Supportive care | |||
| Norepinephrine | 5 (29.4) | 5 (41.7) | 0.49 |
| Mechanical ventilation | 12 (70.6) | 12 (100) | 0.04 |
| CRRT | 3 (17.6) | 5 (41.7) | 0.154 |
| Immunotherapy | 1 (5.8) | 2 (33.3) | 0.55 |
| Laboratory values at admission | |||
| Leucocytes (/mm3) | 7520 (5970–9330) | 11,910 (7160–14,750) | 0.082 |
| Neutrophils (/mm3) | 6420 (4880–8310) | 10,010 (6238–12,225) | 0.09 |
| Immature neutrophils (%) | 4 (2.57–7.54) | 4.9 (2.5–6.1) | 0.98 |
| Lymphocytes (/mm3) | 800 (600–1191) | 1235 (663–1442) | 0.143 |
| CD4 (/mm3) | 330 (222.5–526.5) | 333 (240.5–481.5) | 0.917 |
| CD8 (/mm3) | 167 (114.5–257) | 346 (163–399.5) | 0.102 |
| NK (/mm3) | 74 (63.25 -109.25) | 127 (95–249) | 0.046 |
| B (/mm3) | 136 (97.5–279) | 132 (100–333.5) | 0.827 |
| Monocytes (/mm3)a | 198.7 (81.5–284) | 328.6 (170.9–453.8) | 0.03 |
| mHLA-DR (AB/C) | 17,737 (10,060–32,503) | 11,877 (7039–22,702) | 0.3 |
| M-MDSC (%) | 3.8 (0.95–13.96) | 10.25 (4.14–29.32) | 0.04 |
| Immunoglobulin G (g/L) | 9.87 (7.6–11.35) | 10.8 (8.71–13.80) | 0.364 |
| Immunoglobulin M (g/L) | 1.22 (0.7–1.39) | 0.81 (0.63–1.30) | 0.427 |
| Immunoglobulin A (g/L) | 2.73 (2.21–3.3) | 2.49 (2.21–5.02) | 0.584 |
| C3 (g/L) | 1.28 (1.05–1.43) | 1.4 (1.15–1.45) | 0.568 |
| C4 (g/L) | 0.27 (0.23–0.36) | 0.29 (0.22–0.34) | 0.765 |
| CH50 (U/mL) | 70 (56.5–73.3) | 70 (57–73) | 0.943 |
| Platelets (× 103/mm3) | 271(182–340) | 444(263–503.7) | 0.097 |
| Fibrinogen (mg/dL) | 7.3 (6.5–8.1) | 8.1 (7–8.3) | 0.28 |
| d-dimers (g/dL) | 2145 (1100–3595) | 2859 (1612–2870) | 0.29 |
| Ferritin (μg/L) | 1223 (818.25–1378.5) | 1691 (303–4406.5) | 0.287 |
| Creatinine (μmol/L) | 67 (50–109) | 88.5 (65.8–145) | 0.25 |
| Total bilirubin (μmol/L) | 9 (6–12) | 11 (5.75–21.5) | 0.73 |
| PCT (ng/mL) | 0.64 (0.34–2.77) | 0.71(0.36–3.22) | 0.9 |
| CRP (mg/L) | 131.5 (89.7–210.5) | 188(98.5–265) | 0.34 |
| Outcome | |||
| 28-day mortality | 3 (17.6) | 3 (25) | 0.63 |
| 60-day mortality | 5 (29.4%) | 6 (50) | 0.26 |
| PICU length of stay | 10 (7–15) | 26 (21.5–28) | 0.0001 |
Values are expressed as median (IQR) or number (%)
BMI, body mass index; SOFA, Sequential Organ Failure Assessment; SAPS, Simplified Acute Physiological Score; CRRT, continuous renal replacement therapy; CD, cluster of differentiation; mHLA-DR, monocyte histocompatibility leucocyte antigen-DR; M-MDSC, monocyte myeloid-derived suppressor cell (CD11b+ HLA-DR−), C, complement; CH50, total complement activity; PCT, procalcitonin; CRP, C-reactive protein; PICU, pediatric intensive care unit
aTotal monocytes: CD19− CD14+ CD15−, monocytes subtypes based on CD11b and HLA-DR