Risk stratification biomarkers for Staphylococcus aureus bacteraemia

Area of Science:

• Infectious Diseases
• Biomarker Discovery
• Clinical Microbiology

Background:

• Staphylococcus aureus bacteraemia (SAB) can lead to severe deep-seated infections, high mortality, and morbidity.
• Accurate risk stratification is crucial for effective patient management and clinical trial enrollment.
• Identifying reliable biomarkers for early risk assessment in SAB is an unmet clinical need.

Purpose of the Study:

• To identify and validate biomarkers for risk stratification in patients with Staphylococcus aureus bacteraemia.
• To predict the development of deep-seated infections, persistent bacteraemia, and mortality.
• To guide clinical trial enrollment and optimize patient management strategies.

Main Methods:

• A validation cohort of 160 patients with S. aureus bacteraemia was analyzed.
• Prognostic value of eight biomarkers was evaluated for persistent bacteraemia, mortality, and endovascular infection.
• Biomarker performance was assessed using predefined thresholds from an independent cohort.

Main Results:

• High levels of IL-17A, IL-10, and soluble E-selectin correlated with prolonged bacteraemia.
• These biomarkers robustly predicted persistent bacteraemia and endovascular infections.
• IL-17A and IL-10 levels predicted mortality and microbiological failure, outperforming clinical metrics and infective endocarditis diagnosis.

Conclusions:

• Identified biomarkers (IL-17A, IL-10, sE-selectin) can stratify risk in S. aureus bacteraemia patients.
• Biomarker levels can guide decisions on diagnostic imaging, such as transesophageal echocardiography (TEE).
• These biomarkers facilitate clinical trial enrichment for patients with high-risk infections, enabling targeted therapeutic development.