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<p>The present study estimated lipopolysaccharide (LPS)-induced tumor necrosis factor-alpha (TNF-α) levels and its association with health care associated infection (HAI) and duration of multi-organ dysfunction syndrome (MODS). LPS-induced TNF-α levels were estimated in 67 children on day 3 of MODS. Variables recorded were Pediatric Index of Mortality (PIM-3), cultures, diagnosis, HAI, days of MODS, survivors and non-survivors. Of 67 children, 37 (52.2%) were male and 27 (40.2%) expired. Sixty-three (94%) children had reduced TNF-α levels (&lt;200 pg/ml); 23.11 (10.38, 40.59). The median number of days in MODS was 7 (5, 12) and prolonged MODS (≥7 d) was observed in 49/67 (73.1%) children. Forty-five (67.1%) children had HAI, among these 33/45 (73.3%) had ventilator associated pneumonia (VAP). TNF-α levels were significantly lower in children with MODS, prolonged MODS, children who developed HAI and non-survivors as compared to healthy children (<i>p</i> &lt;0.0001), children with MODS &lt;7 d (<i>p</i>=0.01), children without HAI (<i>p</i>=0.009) and survivors (<i>p</i>=0.04), respectively. HAI was independently associated with reduced levels of TNF-α (<i>p</i>=0.01).</p>

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Lipopolysaccharide (LPS)-Induced Tumor Necrosis Factor-Alpha (TNF-ɑ) Levels and Health Care Associated Infection (HAI) in Children with Multi-Organ Dysfunction Syndrome (MODS)

  • 期刊论文

  • 发表日期：

    2025年4月10日

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  • Shiva Manwatkar,
  • Anil Kumar Saroj,
  • Sandip Kumar,
  • Kamlesh Palandurkar,
  • Sunil Kumar Rao

摘要

The present study estimated lipopolysaccharide (LPS)-induced tumor necrosis factor-alpha (TNF-α) levels and its association with health care associated infection (HAI) and duration of multi-organ dysfunction syndrome (MODS). LPS-induced TNF-α levels were estimated in 67 children on day 3 of MODS. Variables recorded were Pediatric Index of Mortality (PIM-3), cultures, diagnosis, HAI, days of MODS, survivors and non-survivors. Of 67 children, 37 (52.2%) were male and 27 (40.2%) expired. Sixty-three (94%) children had reduced TNF-α levels (<200 pg/ml); 23.11 (10.38, 40.59). The median number of days in MODS was 7 (5, 12) and prolonged MODS (≥7 d) was observed in 49/67 (73.1%) children. Forty-five (67.1%) children had HAI, among these 33/45 (73.3%) had ventilator associated pneumonia (VAP). TNF-α levels were significantly lower in children with MODS, prolonged MODS, children who developed HAI and non-survivors as compared to healthy children (p <0.0001), children with MODS <7 d (p=0.01), children without HAI (p=0.009) and survivors (p=0.04), respectively. HAI was independently associated with reduced levels of TNF-α (p=0.01).