Effect of Nonviable Tissue and Abscesses on Complement Depletion and the Development of Bacteremia

Abstract

Complement (C) concentrations and blood cultures were compared in 58 patients within 24 h of injury and weekly thereafter. Extensive amounts of nonviable tissue (40 patients) were associated with a mean depletion of C4, C3 and C5 by 56%, and minor injuries (18 patients) by 22% of normal concentration wihtin 24 h aftery injury. The C4, C3 and C5 concentrations returned to normal or above within 1 wk after minor injuries, but not follolwing major injuries. C4, C3 and C5 levels remained depressed after major injuries unless necrotic tissue was removed or abscesses were drained. If C concentration was < 50% of normal for > 1 wk, all patients developed bacteremia. Following debridement or drainage, C returned to normal in 11 patients and blood cultures became negative in 7 patients. Possible consequences by activation and altered availability of C for chemotaxis, opsonization and lysis of bacteria have been analyzed and related to the development of bacteremia.