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

Area of Science:

• Infectious Diseases
• Immunology
• Biomarker Discovery

Background:

• Early diagnosis of streptococcal necrotizing soft tissue infections (NSTIs) is difficult, often confused with cellulitis.
• Understanding inflammatory responses in streptococcal infections is crucial for timely intervention and novel diagnostic development.

Purpose of the Study:

• To identify potential biomarkers differentiating streptococcal NSTIs from cellulitis.
• To explore inflammatory mediator profiles associated with disease severity and outcomes in NSTIs.

Main Methods:

• Compared plasma levels of 37 mediators, leucocytes, and CRP in 102 NSTI patients versus 23 cellulitis patients.
• Utilized hierarchical cluster analyses to identify distinct patterns.
• Evaluated biomarker performance using Area Under the Curve (AUC).

Main Results:

• Significant differences in mediator levels were found between NSTI and cellulitis, notably IL-1β, TNFα, and CXCL8 (AUC >0.90).
• Eight biomarkers distinguished NSTI cases with septic shock from those without.
• Four mediators predicted severe outcomes in streptococcal NSTIs.

Conclusions:

• Identified several inflammatory mediators as potential diagnostic biomarkers for NSTIs.
• Biomarker profiles can aid in differentiating infection types and predicting patient outcomes, improving clinical management.