OBJECTIVE To analyze the etiological characteristics of sepsis patients, changes in serum levels of proprotein convertase subtilisin/kexin type 9 (PCSK9), pentraxin 3 (PTX-3) and histone deacetylase 2 (HDAC2) in patients with sepsis and their relationship with the severity of the disease and prognosis.

METHODS A total of 156 sepsis patients admitted to Wuhan No.8 Hospital (Wuhan Anorectal Hospital) from Jan. 2020 to Apr. 2022 were selected as the study group. They were divided into the general sepsis, severe sepsis and septic shock groups according to their condition, with 58, 51 and 47 cases, respectively. According to the clinical outcome at day 28 post-admission, the patients were divided into the good prognosis and poor prognosis groups with 124 and 32 cases, respectively. Additionally, 50 healthy individuals were randomly selected as the control group. The etiological characteristics in patients with sepsis were analyzed. Serum levels of PCSK9, PTX-3 and HDAC2 were compared among different severity groups and prognosis groups. The predictive value was assessed by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC).

RESULTS A total of 162 strains were detected from 156 sepsis patients, with gram-negative bacteria accounted for 56.79%. Serum levels of PCSK9 and PTX-3 were higher in the study group than those in the control group, while serum level of HDAC2 was lower than that in the control group (P < 0.05). Serum levels of PCSK9 and PTX-3 showed a gradual increase among the general sepsis group, severe sepsis group, and septic shock group, while serum level of HDAC2 showed a decreasing trend among the three groups (P < 0.05). Serum levels of PCSK9 and PTX-3 were higher in the poor prognosis group than those in the good prognosis group, and serum level of HDAC2 was lower than that in the good prognosis group (P < 0.05). ROC analysis showed that the AUC value of the combined detection of serum PCSK9, PTX-3 and HDAC2 was 0.931, higher than that of single markers (P < 0.05), with sensitivity and specificity of 90.62% and 81.45%, respectively.

CONCLUSIONS The pathogens in patients with sepsis are primarily gram-negative bacteria. Serum levels of PCSK9 and PTX-3 are high in patients, while serum HDAC2 is low. All the three markers are closely related to the patient′s condition and prognosis, and their combined detection offers a more advantageous approach for predicting the poor prognosis of patients with sepsis.