Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia?
Background: Bloodstream infections are a leading cause of mortality. Their detection relies on blood cultures (BCs) but time to positivity is often between tens of hours and days. d-lactate is a metabolite widely produced by bacteria but very few in human. We aimed to evaluate d-lactate, d-lactate/l...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023036733 |
| _version_ | 1797820685888782336 |
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| author | Charles R. Lefèvre Adrien Turban David Luque Paz Malo Penven Céline René Bénédicte Langlois Maxime Pawlowski Nicolas Collet Caroline Piau Vincent Cattoir Claude Bendavid |
| author_facet | Charles R. Lefèvre Adrien Turban David Luque Paz Malo Penven Céline René Bénédicte Langlois Maxime Pawlowski Nicolas Collet Caroline Piau Vincent Cattoir Claude Bendavid |
| author_sort | Charles R. Lefèvre |
| collection | DOAJ |
| description | Background: Bloodstream infections are a leading cause of mortality. Their detection relies on blood cultures (BCs) but time to positivity is often between tens of hours and days. d-lactate is a metabolite widely produced by bacteria but very few in human. We aimed to evaluate d-lactate, d-lactate/l-lactate ratio and d-lactate/total lactate ratio in plasma as potential early biomarkers of bacteraemia on a strictly biological standpoint. Methods: A total of 228 plasma specimens were collected from patients who had confirmed bacteraemia (n = 131) and healthy outpatients (n = 97). Specific l-lactate and d-lactate analyses were performed using enzymatic assays and analytical performances of d-lactate, d-lactate/total lactate and d-lactate/l-lactate ratios for the diagnosis of bacteraemia were assessed. Results: A preliminary in vitro study confirmed that all strains of Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were able to produce d-lactate at significant levels. In patients, plasma d-lactate level was the most specific biomarker predicting a bacteraemia profile with a specificity and predictive positive value of 100% using a cut-off of 131 μmol.L−1. However, sensitivity and negative predictive value were rather low, estimated at 31% and 52%, respectively. d-lactate displayed an Area Under Receiver Operating Characteristic (AUROC) curve of 0.696 with a P value < 0.0001. There was no difference of d-lactate levels between BCs bottles positive for Gram-positive or Gram-negative bacteria (p = 0.55). Conclusion: d-lactate shows promise as a specific early biomarker of bacterial metabolism. The development of rapid automated assays could raise clinical applications for infectious diseases diagnosis including early bacteraemia prediction. |
| first_indexed | 2024-03-13T09:41:54Z |
| format | Article |
| id | doaj.art-d81666b58f8542c3b15834847923d198 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-13T09:41:54Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-d81666b58f8542c3b15834847923d1982023-05-25T04:24:42ZengElsevierHeliyon2405-84402023-06-0196e16466Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia?Charles R. Lefèvre0Adrien Turban1David Luque Paz2Malo Penven3Céline René4Bénédicte Langlois5Maxime Pawlowski6Nicolas Collet7Caroline Piau8Vincent Cattoir9Claude Bendavid10Biochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, France; Corresponding author. Biochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, 2 rue Henri Le Guilloux, 35000, Rennes, France.Bacteriology Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceInfectious Diseases and Intensive Care Unit, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBacteriology Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBiochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceMicrobiology Department, University Hospital of Caen, Caen, FranceBiochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBiochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBacteriology Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBacteriology Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBiochemistry Laboratory, Pontchaillou Hospital, Rennes University Hospital, Rennes, FranceBackground: Bloodstream infections are a leading cause of mortality. Their detection relies on blood cultures (BCs) but time to positivity is often between tens of hours and days. d-lactate is a metabolite widely produced by bacteria but very few in human. We aimed to evaluate d-lactate, d-lactate/l-lactate ratio and d-lactate/total lactate ratio in plasma as potential early biomarkers of bacteraemia on a strictly biological standpoint. Methods: A total of 228 plasma specimens were collected from patients who had confirmed bacteraemia (n = 131) and healthy outpatients (n = 97). Specific l-lactate and d-lactate analyses were performed using enzymatic assays and analytical performances of d-lactate, d-lactate/total lactate and d-lactate/l-lactate ratios for the diagnosis of bacteraemia were assessed. Results: A preliminary in vitro study confirmed that all strains of Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were able to produce d-lactate at significant levels. In patients, plasma d-lactate level was the most specific biomarker predicting a bacteraemia profile with a specificity and predictive positive value of 100% using a cut-off of 131 μmol.L−1. However, sensitivity and negative predictive value were rather low, estimated at 31% and 52%, respectively. d-lactate displayed an Area Under Receiver Operating Characteristic (AUROC) curve of 0.696 with a P value < 0.0001. There was no difference of d-lactate levels between BCs bottles positive for Gram-positive or Gram-negative bacteria (p = 0.55). Conclusion: d-lactate shows promise as a specific early biomarker of bacterial metabolism. The development of rapid automated assays could raise clinical applications for infectious diseases diagnosis including early bacteraemia prediction.http://www.sciencedirect.com/science/article/pii/S2405844023036733D-lactateBacteraemiaSpecificBiomarkerSepsisInfection |
| spellingShingle | Charles R. Lefèvre Adrien Turban David Luque Paz Malo Penven Céline René Bénédicte Langlois Maxime Pawlowski Nicolas Collet Caroline Piau Vincent Cattoir Claude Bendavid Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? Heliyon D-lactate Bacteraemia Specific Biomarker Sepsis Infection |
| title | Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? |
| title_full | Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? |
| title_fullStr | Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? |
| title_full_unstemmed | Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? |
| title_short | Early detection of plasma d-lactate: Toward a new highly-specific biomarker of bacteraemia? |
| title_sort | early detection of plasma d lactate toward a new highly specific biomarker of bacteraemia |
| topic | D-lactate Bacteraemia Specific Biomarker Sepsis Infection |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023036733 |
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