Introduction
Regarding the great amount of negative blood cultures, timely diagnosis of bacterial sepsis is not an easy goal. Thus, it seems that detection of certain factors such as TLR molecules could be helpful for diagnosis of sepsis and guiding appropriate antibiotics. The aim of this study was comparison of TLR2 and TLR4 gene expression in negative culture bacterial septic patients with healthy people.
Materials and Methods
This case control study was performed on 30 negative culture bacterial septic patients and 30 healthy people, in 2012. The data were analyzed by SPSS soft ware and cutoff ratios were calculated by R soft ware.
Results
The levels of TLR2 and TLR4 genes expression in negative culture and healthy control did not have any significant difference (p value TLR2:0.52) and (p value TLR4:0.099). The TLR4 gene expression in patients who had gram positive cocci sample smear but negative blood cultures in comparison to healthy control was significantly higher (p value: 0.004).  Meanwhile, regarding TLR2 there was no difference (p value: 0.0928).
Conclusion
TLR4 gene expression in patients with SOFA SCORE 0-3 in comparison to healthy controls had significant difference (with cut-off ratio of 9.54 and sensitivity and specificity of 67% and 71%). The same was true for negative blood culture bacterial sepsis in comparison to healthy controls, with cut-off ratio of 46.19 and sensitivity and specificity of 87% and 78%, respectively. So, evaluation of TLR4 gene expression may be useful to consider anti staphylococcus antibiotic therapy for patients with negative culture bacterial sepsis.