Serum biomarkers to differentiate Gram-negative, Gram-positive and fungal infection in febrile patients
| Autor: | Lian-An Ding, Hong-Chun Fang, Qian Huang, Chen Li, Dong-Guang Niu, Fan Yang, Wei-Liang Tian, Yun-Zhao Zhao |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Adult Calcitonin Male medicine.medical_specialty Adolescent Fever Neutrophils Lymphocyte Microbiology Gastroenterology Procalcitonin 03 medical and health sciences Young Adult 0302 clinical medicine Serum biomarkers Internal medicine Bloodstream infection medicine Humans 030212 general & internal medicine Lymphocytes Gram-Positive Bacterial Infections Gram Aged Retrospective Studies Receiver operating characteristic business.industry Interleukin-6 Discriminant Analysis General Medicine Middle Aged medicine.disease Blood Cell Count medicine.anatomical_structure C-Reactive Protein Mycoses ROC Curve 030220 oncology & carcinogenesis Bacteremia Culture negative business Gram-Negative Bacterial Infections Biomarkers |
| Zdroj: | Journal of medical microbiology. 70(7) |
| ISSN: | 1473-5644 |
| Popis: | Introduction. Contamination of specimens and overuse of broad spectrum antibiotics contribute to false positives and false negatives, respectively. Therefore, useful and applicable biomarkers of bacteremia are still required. Hypothesis/Gap Statement. IL-6 can be used as a serum biomarker to discriminate among bacterial infections and fungal infections in febrile patients with a bloodstream infection. Aim. We aimed to evaluate the diagnostic efficiency of neutrophil/lymphocyte ratio (NLR), procalcitonin (PCT) and interleukin-6 (IL-6) in discriminating Gram-negative (G−) bacteria from Gram-positive (G+) bacteria and fungi in febrile patients. Methodology. A total of 567 patients with fever were evaluated. Serum levels of IL-6, PCT, NLR and CRP were compared among a G− group (n=188), a G+ group (n=168), a fungal group (n=38) and a culture negative group (n=173). Sensitivity, specificity, Yuden’s index and area under the Receiver operating characteristic (ROC) curve (AUC) were obtained to analyse the diagnostic abilities of these biomarkers in discriminating bloodstream infection caused by different pathogens. Results. Serum IL-6 and PCT in the G− group increased significantly when compared with both the G+ group and fungal group (P − group from G+ group. When discriminating the G− group from fungal group, the AUC of IL-6 (0.695, 95 % CI:0.651–0.747) with a cut-off value of 464.3 pg ml−1 was also higher than the AUC of PCT (0.630, 95 % CI:0.585–0.688) with a cut-off value of 0.68 ng ml−1. Additionally, AUC of NLR (0.685, 95 % CI:0.646–0.727) in discriminating the fungal group from G+ group at the cut-off value of 9.03, was higher than AUC of IL-6, PCT and CRP. Conclusion. This study suggests that IL-6 could be used as a serum biomarker to discriminate among bacterial infections and fungal infections in febrile patients with a bloodstream infection. In addition, NLR is valuable to discriminate fungal infections from Gram-positive infections in febrile patients with a bloodstream infection. |
| Databáze: | OpenAIRE |
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