TY - JOUR
T1 - Systemic immune activation profiles in streptococcal necrotizing soft tissue infections
T2 - A prospective multicenter study
AU - Rath, Eivind
AU - Palma Medina, Laura M
AU - Jahagirdar, Sanjeevan
AU - Mosevoll, Knut A
AU - Damås, Jan K
AU - Madsen, Martin B
AU - Svensson, Mattias
AU - Hyldegaard, Ole
AU - Martins Dos Santos, Vitor A P
AU - Saccenti, Edoardo
AU - Norrby-Teglund, Anna
AU - Skrede, Steinar
AU - Bruun, Trond
AU - INFECT study group
PY - 2023/4
Y1 - 2023/4
N2 - 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.
AB - 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.
KW - Biomarker
KW - Cellulitis
KW - Necrotizing fasciitis
KW - NSTI
KW - Streptococcus dysgalactiae
KW - Streptococcus pyogenes
UR - http://www.scopus.com/inward/record.url?scp=85150038685&partnerID=8YFLogxK
U2 - 10.1016/j.clim.2023.109276
DO - 10.1016/j.clim.2023.109276
M3 - Journal article
C2 - 36871764
SN - 1521-6616
VL - 249
SP - 1
EP - 11
JO - Clinical immunology (Orlando, Fla.)
JF - Clinical immunology (Orlando, Fla.)
M1 - 109276
ER -