The microbial etiology and source of sepsis influence the inflammatory response. Therefore, the plasma levels of cytokines (IL-6, IL-8, and IL-10), chemokines (CCL2/MCP-1, MIP-1β), heparin-binding protein (HBP), soluble CD14 (sCD14), and cortisol were analyzed in blood from septic patients obtained during the first 96 hours of intensive care unit hospitalization. The etiology was established in 56 out of a total of 62 patients enrolled in the study. Plasma concentrations of MCP-1, sCD14, IL-6, and IL-10 were significantly higher in patients with community-acquired pneumonia (CAP; n = 10) and infective endocarditis (IE; n = 11) compared to those with bacterial meningitis (BM; n = 18). Next, cortisol levels were higher in IE patients than in those with BM and CAP, and at one time point, cortisol was also higher in patients with gram-negative sepsis when compared to those with gram-positive infections. Furthermore, cortisol and MCP-1 levels correlated positively with the daily measured SOFA score. In addition, HBP levels were significantly higher in patients with IE than in those with BM. Our findings suggest that MCP-1, sCD14, IL-6, IL-10, cortisol, and HBP are modulated by the source of sepsis and that elevated MCP-1 and cortisol plasma levels are associated with sepsis-induced organ dysfunction.

Department of Anesthesiology and Intensive Care Medicine University Hospital of Ostrava 17 listopadu 708 52 Ostrava Czech Republic

Department of Clinical Sciences Division of Infection Medicine Lund University Sölvegatan 19 221 00 Lund Sweden

Department of Infectious Diseases 1st Faculty of Medicine Charles University and Military University Hospital Prague U Vojenské nemocnice 1200 169 02 Praha 6 Czech Republic

Department of Infectious Diseases 3rd Faculty of Medicine Charles University and Na Bulovce Hospital Budínova 2 180 81 Praha 8 Czech Republic

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