Dynamic cytokine profiles of bloodstream infection caused by Klebsiella pneumoniae in China.

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Wei Yu, Linyan Zeng, Xiang Lian, Lushun Jiang, Hao Xu, Wenhui Guo, Beiwen Zheng, Yonghong Xiao
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引用次数: 0

Abstract

Objectives: The aim of this work was to assess dynamic cytokine profiles associated with bloodstream infection (BSI) caused by Klebsiella pneumoniae (Kpn) and investigate the clinical features associated with mortality.

Methods: A total of 114 patients with positive BSI-Kpn and 12 sepsis individuals without blood positive bacteria culture were followed up. Cytokine profiles were analyzed by multiplex immunoassay on the first, third, seventh and fourteenth day after diagnosis. The test cytokines included arginase, interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-12 (p70), and IL-23. The minimum inhibitory concentration (MIC) of 24 antibiotics were tested for BSI-Kpn. Risk factors associated with the 30-day mortality and 120-day mortality were evaluated using logistic analyses and nomogram.

Results: There were 55 out of 114 patients with BSI-Kpn were included. All isolates showed high susceptibility rate to novel avibactam combinations. The level of arginase was the highest in carbapenem-resistant Kpn (CRKP) patients. The AUCs of arginase, TNF-α and IL-4 reached 0.726, 0.495, and 0.549, respectively, whereas the AUC for the combination of these three cytokines was 0.805. Notably, 120-day mortality in patients with CRKP was higher than carbapenem-sensitive K. pneumoniae (CSKP). Furthermore, the long-term and high levels of IL-6 and IL-10 were associated with death.

Conclusions: High expression of arginase is correlated with CRKP. In addition, BSI-CRKP could result in indolent clinic course but poor long-term prognosis. Continuous increase of IL-6 and IL-10 were associated with mortality.

中国肺炎克雷伯菌引起的血流感染的动态细胞因子谱。
目的:本研究旨在评估与肺炎克雷伯菌(Kpn)引起的血流感染(BSI)相关的动态细胞因子谱,并调查与死亡率相关的临床特征:本研究旨在评估与肺炎克雷伯氏菌(Kpn)引起的血流感染(BSI)相关的动态细胞因子谱,并调查与死亡率相关的临床特征:方法: 共对 114 名 BSI-Kpn 阳性患者和 12 名无血液细菌培养阳性的败血症患者进行了随访。在确诊后的第一天、第三天、第七天和第十四天,采用多重免疫测定法分析细胞因子谱。检测的细胞因子包括精氨酸酶、γ-干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-4、IL-6、IL-10、IL-12(p70)和 IL-23。对24种抗生素的最低抑菌浓度(MIC)进行了BSI-Kpn检测。使用逻辑分析和提名图评估了与 30 天死亡率和 120 天死亡率相关的风险因素:结果:114 名 BSI-Kpn 患者中有 55 名被纳入研究。结果:114 名 BSI-Kpn 患者中有 55 人,所有分离菌株对新型阿维菌素组合均表现出高度敏感性。耐碳青霉烯类药物的 Kpn(CRKP)患者精氨酸酶水平最高。精氨酸酶、TNF-α和IL-4的AUC分别为0.726、0.495和0.549,而这三种细胞因子组合的AUC为0.805。值得注意的是,CRKP 患者的 120 天死亡率高于碳青霉烯类敏感肺炎双球菌(CSKP)患者。此外,长期高水平的IL-6和IL-10与死亡有关:结论:精氨酸酶的高表达与 CRKP 相关。结论:精氨酸酶的高表达与 CRKP 相关,此外,BSI-CRKP 可导致临床症状不明显,但长期预后不良。IL-6和IL-10的持续升高与死亡率有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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