Aims: 

The role of platelets in early host defence is long debated. The aim of this study was to assess whether platelet microparticle (MP) number changes can predict the development of fungal sepsis during intensive care unit stay.

Methods: 

We have examined severe septic patients (n=33, 2 or more organ dysfunctions and procalcitonin levels 5 ng/ml or above) and followed MP number changes on admission (1^st day) and the following 3^rd and 5^th days. For microbiological identification, multiple specimens (hemoculture, bronchial lavage fluid and urine) were collected on admission and in case of overall status deterioration. MP measurements were carried out using flow cytometry. Twenty volunteers were invited to determine healthy baseline values.

Results: 

Fungal septic patients showed elevated Annexin V positive MP number throughout our study which was significant on the 1^st day (p < 0.05). The constitutive platelet marker (CD41) positive MP numbers were statistically elevated on the 1^st day (p < 0.05). CD42a⁺ adhesive marker positive vesicles were negligible in the non-fungal group, while fungal septic patients showed significantly elevated numbers in all measurements (p < 0.01). The activated platelet fibrinogen receptor (PAC1) harbouring MPs had elevated numbers in the fungal septic group on the 1^st and 5^th study days compared to non-fungal septic patients (p < 0.05).

Conclusion: 

The rapid measurement of CD42a and PAC1 positive MPs on admission can possibly help to improve therapy thus overall outcome of severe septic patients.

Support: 

OTKA 78480