Systemic immune activation profiles in streptococcal necrotizing soft tissue infections: A prospective multicenter study

Eivind Rath*, Laura M. Palma Medina, S.R. Jahagirdar, Knut A. Mosevoll, Jan K. Damas, Martin Bruun Madsen, Mattias Svenson, Ole Hyldegaard, V.A.P. Martins dos Santos, E. Saccenti, Anna Norrby-teglund, Steinar Skrede, Trond Bruun

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

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.
Original languageEnglish
Article number109276
JournalClinical Immunology
Volume249
DOIs
Publication statusPublished - Apr 2023

Keywords

  • Biomarker Cellulitis Necrotizing fasciitis NSTI Streptococcus dysgalactiae Streptococcus pyogenes

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