• Estelle Peronnet, Fabienne Venet, Delphine Maucort-Boulch, Arnaud Friggeri, Martin Cour, Laurent Argaud, Bernard Allaouchiche, Bernard Floccard, Frédéric Aubrun, Thomas Rimmelé, Fabrice Thiolliere, Vincent Piriou, Julien Bohé, Marie-Angélique Cazalis, Véronique Barbalat, Guillaume Monneret, Stéphane Morisset, Julien Textoris, Hélène Vallin, Alexandre Pachot, Alain Lepape, and MIP Rea Study Group.
• EA7426 Hospices Civils de Lyon, bioMérieux, UCBL1 "Pathophysiology of Injury Induced Immunosuppression", Groupement Hospitalier Edouard Herriot, Lyon, France. estelle.peronnet@biomerieux.com.
• Intensive Care Med. 2017 Jul 1; 43 (7): 1013-1020.

PurposeIntensive care unit (ICU)-acquired infections (IAI) result in increased hospital and ICU stay, costs and mortality. To date, no biomarker has shown sufficient evidence and ease of application in clinical routine for the identification of patients at risk of IAI. We evaluated the association of the systemic mRNA expression of two host response biomarkers, CD74 and IL10, with IAI occurrence in a large cohort of ICU patients.MethodsICU patients were prospectively enrolled in a multicenter cohort study. Whole blood was collected on the day of admission (D1) and on day 3 (D3) and day 6 (D6) after admission. Patients were screened daily for IAI occurrence and data were censored after IAI diagnosis. mRNA expression levels of biomarkers were measured using RT-qPCR. Fine and Gray competing risk models were used to assess the association between gene expression and IAI occurrence.ResultsA total of 725 patients were analyzed. At least one IAI episode occurred in 137 patients (19%). After adjustment for shock and sepsis status at admission, CD74 and IL10 levels were found to be significantly associated with IAI occurrence [subdistribution hazard ratio (95% confidence interval) 0.67 (0.46-0.97) for CD74 D3/D1 expression ratio and 2.21 (1.63-3.00) for IL10 at D3]. IAI cumulative incidence was significantly different between groups stratified according to CD74 or IL10 expression (Gray tests p < 0.001).ConclusionOur results suggest that two immune biomarkers, CD74 and IL10, could be relevant tools for the identification of IAI risk in ICU patients.

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