The current study evaluated the potential of clinical parameters and circulating
biomarkers to distinguish
sepsis from SIRS in patients admitted with systemic
inflammation. Clinical parameters, leukocyte counts and platelets were measured on admission. Circulating
C-reactive protein (CRP),
procalcitonin (PCT) and
cytokine concentrations were quantified using
laser immunonephelometry, immunoluminescence and a Bio-Plex
suspension bead array system respectively. Blood, sputum, urine, peritoneal and cerebrospinal fluid were sent for microscopy and culture. Based on clinical information and the results of microbiological testing, 62 patients were classified retrospectively into 2 groups, those with
sepsis (n = 37) or SIRS (n = 25). Mean body temperature was higher and blood pressure lower in the
sepsis patients. Circulating concentrations of CRP, PCT,
interleukin (IL)-10 and
IL-1 receptor antagonist (IL-1Ra) were significantly higher in patients with
sepsis, with
IL-10 identified as the best
biomarker in differentiating
sepsis from SIRS. The
biomarkers that best predicted overall mortality were platelet counts >PCT ≥ CRP > IL-6 > IL-1Ra. These findings demonstrate that patients with
sepsis have significantly increased levels of the immunosuppressive/anti-inflammatory
cytokines,
IL-1Ra and
IL-10, compared to those with SIRS, consistent with a more intense counteracting anti-inflammatory response, while a
biomarker profile including platelets, PCT, CRP,
IL-6 and
IL-1Ra may be useful to predict mortality.