BACKGROUND AND HYPOTHESIS The inflammatory response was targeted by unsuccessful therapies but ignored pathogen. We hypothesized that the inflammatory response differs according to organism in human septic shock. MATERIALS AND METHODS We measured 39 cytokines at baseline and 24 h in patients (n = 363) in the Vasopressin and Septic Shock Trial (VASST). We compared cytokine profiles (cytokine functional class) at baseline and at 24 h by organism and used hierarchical clustering to classify cytokines according to 28-day outcomes. RESULTS In 363 patients, 88 and 176 patients had at least 1 species isolated from blood and other sites, respectively. Cytokine levels differed significantly according to organism: Neisseria meningitidis and Streptococcus pneumoniae had the highest (baseline and at 24 h), while Enterococcus faecalis (blood) had the lowest mean cytokine levels. N. meningitidis and Klebsiella pneumoniae had significantly higher cytokine levels at baseline versus 24 h (p = 0.01 and 0.02, respectively); E. faecalis had significantly higher cytokine levels at 24 h versus baseline. Hierarchical clustering heat maps showed that pathogens elicited similar cytokine responses not related to the functional cytokine class. CONCLUSION The organism type induces different cytokine profiles in septic shock. Specific gram-positive and gram-negative pathogens stimulated similar plasma cytokine-level patterns.

中文翻译：

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特定生物体：非细菌 革兰氏类型：在脓毒性休克中驱动炎症反应。

背景和假设 炎症反应是不成功的治疗的目标，但忽略了病原体。我们假设炎症反应因人类感染性休克中的生物体而异。材料和方法 我们在血管加压素和脓毒性休克试验 (VASST) 中测量了患者 (n = 363) 在基线和 24 小时时的 39 种细胞因子。我们比较了基线和 24 小时生物体的细胞因子谱（细胞因子功能类别），并使用层次聚类根据 28 天结果对细胞因子进行分类。结果 在363例患者中，88例和176例患者分别从血液和其他部位分离到至少1种。细胞因子水平因生物体而异：脑膜炎奈瑟菌和肺炎链球菌最高（基线和 24 小时），而粪肠球菌（血液）的平均细胞因子水平最低。与 24 小时相比，脑膜炎奈瑟氏菌和肺炎克雷伯菌在基线时的细胞因子水平显着升高（分别为 p = 0.01 和 0.02）；与基线相比，粪肠球菌在 24 小时时具有显着更高的细胞因子水平。分层聚类热图显示病原体引发了与功能性细胞因子类别无关的类似细胞因子反应。结论 生物体类型在感染性休克中诱导不同的细胞因子谱。特定的革兰氏阳性和革兰氏阴性病原体刺激相似的血浆细胞因子水平模式。分层聚类热图显示病原体引发了与功能性细胞因子类别无关的类似细胞因子反应。结论 生物体类型在感染性休克中诱导不同的细胞因子谱。特定的革兰氏阳性和革兰氏阴性病原体刺激相似的血浆细胞因子水平模式。分层聚类热图显示病原体引发了与功能性细胞因子类别无关的类似细胞因子反应。结论 生物体类型在感染性休克中诱导不同的细胞因子谱。特定的革兰氏阳性和革兰氏阴性病原体刺激相似的血浆细胞因子水平模式。