Diagnostic efficacy of serum cytokines and chemokines in patients with candidemia and bacteremia. (June 2020)

• Record Type: Journal Article
• Authors: Wang, Qi; Wang, Chi; Yang, Ming; Li, Xinjun; Cui, Jiayue; Wang, Chengbin
• Is Part Of: Cytokine. Volume 130(2020)
• Publication Date: 2020-06
• Subjects: Candidemia -- Bacteremia -- Biomarkers -- Cytokine -- Chemokine; BSI bloodstream infection -- AUC area under the curve -- CRP C-reactive protein -- PCT procalcitonin -- WBC white blood cell -- N% percentage of neutrophil -- L% percentage of lymphocyte -- NLR ratio of neutrophil and lymphocyte -- MALDI-TOF-MS Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry -- NGS next generation sequencing -- IL interleukin -- G-CSF granulocyte colony-stimulating factor -- IFN interferon -- TNF tumor necrosis factor -- MIP-1β macrophage inflammatory protein-1β -- RANTES regulated on activation normal T cell expressed and secreted -- CCL5 chemokine (C-C motif) ligand 5 -- NK nature killer -- TLR Toll like receptor -- Th T helper -- DC dendritic cell -- MCP-1 monocyte chemotactic protein 1; Cytokines -- Periodicals; 571.844
• DOI: 10.1016/j.cyto.2020.155081
• Languages: English
• ISSNs: 1043-4666

Abstract

Abstract: Background: The role of serum cytokines/chemokines in differential diagnosis between fungal infections and bacterial infections have not been fully understood. This study aims to measure the serum levels of cytokines/chemokines in cases of candidemia and to compare them with those observed in cases of bacteremia. Material and Methods: Patients with febrile episodes and were identified as bloodstream infections through blood culture were enrolled, while healthy people were included as control group. Fourteen serum cytokine and chemokine levels were detected with multiplex platform. ROC analysis was performed and an area under the curve (AUC), sensitivity and specificity values were calculated to determine the efficacy of various cytokines and chemokines for candidemia and bacteremia. Binary logistic regression was performed to further explore the combination mode of cytokines and chemokines, which could increase the diagnostic efficiency. Results: We included 40 patients with an episode of microbiologically proven fungal infection, 175 patients with bacteremia (85 with Gram-positive bacteremia and 90 with Gram-negative bacteremia) and another 30 healthy controls. Routine laboratory parameters including CRP and PCT were not statistically significant between candidemia group and bacteremia group (both gram-positive and gram-negative). There were significantly higher levels of IFN-γ, TNF-α, IL-10 and lower levels of IL-3, IL-4 in candidemia group, compared with gram-positive and gram-negative bacteremia groups. G-CSF was significantly lower and MIP-1β was higher in candidemia group, when compared with gram-negative bacteremia group. While IL-6, IL-8 and IL-17 were all significantly higher in candidemia group, when compared with gram-positive bacteremia group. Combination of IFN-γ and IL-17 could improve the diagnostic efficiency between candidemia and gram-positive bacteremia, with the AUROC of 0.873 (95% CI: 0.767–0.929). While combination of G-CSF and MIP-1β improved the diagnostic efficiency between candidemia and gram-negative bacteremia, with the AUROC of 0.896 (95% CI: 0.792–0.939). Conclusion: Our study demonstrates that serum cytokines and chemokines including IFN-γ, MIP-1β, IL-17 and G-CSF could be considered as diagnostic markers to distinguish between candidemia and bacteremia. Combination of these biomarkers might improve the diagnostic efficiency of candidemia when compared with bacteremia.