Abstract
Objective
Early stages with streptococcal necrotizing soft tissue infections (NSTIs) are often difficult to discern from cellulitis. Increased insight into inflammatory responses in streptococcal disease may guide correct interventions and discovery of novel diagnostic targets.
Methods
Plasma levels of 37 mediators, leucocytes and CRP from 102 patients with β-hemolytic streptococcal NSTI derived from a prospective Scandinavian multicentre study were compared to those of 23 cases of streptococcal cellulitis. Hierarchical cluster analyses were also performed.
Results
Differences in mediator levels between NSTI and cellulitis cases were revealed, in particular for IL-1β, TNFα and CXCL8 (AUC >0.90). Across streptococcal NSTI etiologies, eight biomarkers separated cases with septic shock from those without, and four mediators predicted a severe outcome.
Conclusion
Several inflammatory mediators and wider profiles were identified as potential biomarkers of NSTI. Associations of biomarker levels to type of infection and outcomes may be utilized to improve patient care and outcomes.
Early stages with streptococcal necrotizing soft tissue infections (NSTIs) are often difficult to discern from cellulitis. Increased insight into inflammatory responses in streptococcal disease may guide correct interventions and discovery of novel diagnostic targets.
Methods
Plasma levels of 37 mediators, leucocytes and CRP from 102 patients with β-hemolytic streptococcal NSTI derived from a prospective Scandinavian multicentre study were compared to those of 23 cases of streptococcal cellulitis. Hierarchical cluster analyses were also performed.
Results
Differences in mediator levels between NSTI and cellulitis cases were revealed, in particular for IL-1β, TNFα and CXCL8 (AUC >0.90). Across streptococcal NSTI etiologies, eight biomarkers separated cases with septic shock from those without, and four mediators predicted a severe outcome.
Conclusion
Several inflammatory mediators and wider profiles were identified as potential biomarkers of NSTI. Associations of biomarker levels to type of infection and outcomes may be utilized to improve patient care and outcomes.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 109276 |
| Tidsskrift | Clinical Immunology |
| Vol/bind | 249 |
| Antal sider | 11 |
| ISSN | 1521-6616 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:This work was supported by the European Union Seventh Framework Programme (FP7/2007–2013) under the grant agreement [305340] (INFECT project); the Swedish Governmental Agency for Innovation Systems (VINNOVA), Innovation Fund Denmark [no. 8114-00005B] and the Research Council of Norway under the frame of NordForsk [Project no. 90456, PerAID], and the Swedish Research Council, Innovation Fund Denmark [no.8113-00009B], the Research Council of Norway, ZonMw, and DLR Federal Ministry of Education and Research, under the frame of ERA PerMed (Project [2018–151], PerMIT).
Publisher Copyright:
© 2023 The Authors