A Prognostic Model of Persistent Bacteremia and Mortality in Complicated Staphylococcus aureus Bloodstream Infection

Autor: Angelo Clemenzi-Allen, Jason B Dinoso, Amos Baruch, Oleg Mayba, Alessander O Guimaraes, Carrie M. Rosenberger, Melicent C. Peck, Yi Cao, Kyu Hong, Montserrat Carrasco-Triguero, Henry F. Chambers, Johnny Gutierrez, Stacey A. Maskarinec, Catherine A. Koss, Vance G. Fowler, Felicia Ruffin
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Bacteremia
medicine.disease_cause
Severity of Illness Index
prognostic biomarkers
Medical and Health Sciences
0302 clinical medicine
80 and over
Medicine
030212 general & internal medicine
Articles and Commentaries
Chemokine CCL2
Aged
80 and over
screening and diagnosis
Endocarditis
Interleukin-17
Bacterial
Interleukin
Hematology
Staphylococcal Infections
Middle Aged
Biological Sciences
Prognosis
Blood proteins
Anti-Bacterial Agents
Detection
Infectious Diseases
Staphylococcus aureus
Biomarker (medicine)
Female
Interleukin 17
Infection
Microbiology (medical)
Adult
medicine.medical_specialty
030106 microbiology
Sensitivity and Specificity
Microbiology
03 medical and health sciences
Internal medicine
Sepsis
Humans
Aged
business.industry
Interleukin-8
Endocarditis
Bacterial
medicine.disease
Survival Analysis
4.1 Discovery and preclinical testing of markers and technologies
Clinical trial
Emerging Infectious Diseases
Good Health and Well Being
Case-Control Studies
business
Biomarkers
Zdroj: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol 68, iss 9
Popis: BACKGROUND: Staphylococcus aureus is a leading cause of bacteremia, yet there remains a significant knowledge gap in the identification of relevant biomarkers that predict clinical outcomes. Heterogeneity in the host response to invasive S. aureus infection suggests that specific biomarker signatures could be utilized to differentiate patients prone to severe disease, thereby facilitating earlier implementation of more aggressive therapies. METHODS: To further elucidate the inflammatory correlates of poor clinical outcomes in patients with S. aureus bacteremia, we evaluated the association between a panel of blood proteins at initial presentation of bacteremia and disease severity outcomes using 2 cohorts of patients with S. aureus bacteremia (n = 32 and n = 124). RESULTS: We identified 13 candidate proteins that were correlated with mortality and persistent bacteremia. Prognostic modeling identified interleukin (IL)-8 and CCL2 as the strongest individual predictors of mortality, with the combination of these biomarkers classifying fatal outcome with 89% sensitivity and 77% specificity (P < .0001). Baseline IL-17A levels were elevated in patients with persistent bacteremia (P < .0001), endovascular (P = .026) and metastatic tissue infections (P = .012). CONCLUSIONS: These results demonstrate the potential utility of selected biomarkers to distinguish patients with the highest risk for treatment failure and bacteremia-related complications, providing a valuable tool for clinicians in the management of S. aureus bacteremia. Additionally, these biomarkers could identify patients with the greatest potential to benefit from novel therapies in clinical trials.
Databáze: OpenAIRE
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