Predicting Secondary Infections in Septic Shock

The early hyperinflammatory phase of severe sepsis can usually be managed successfully with modern critical care. However, during the subsequent compensatory anti-inflammatory phase that is characterized by immunoparalysis, many patients die of secondary nosocomial opportunistic infections. Such infections are often caused by commensal microorganisms with low pathogenicity.

Leukocyte count, C-reactive protein level, and procalcitonin level are well-evaluated parameters for determining the magnitude of an inflammatory reaction, but a biomarker for assessing immunoparalysis has been lacking. Monocyte human leukocyte antigen (HLA)-DR expression has repeatedly been suggested for this purpose.

In a recent prospective study, researchers in France u…