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Comparative Study
. 2014 Nov 15:14:580.
doi: 10.1186/s12879-014-0580-6.

Cytokine responses to Staphylococcus aureus bloodstream infection differ between patient cohorts that have different clinical courses of infection

Sinead McNicholas, Alida Fe Talento, Joanne O'Gorman, Margaret M Hannan, Maureen Lynch, Catherine M Greene, Hilary Humphreys, Deirdre Fitzgerald-Hughes
Comparative Study

Cytokine responses to Staphylococcus aureus bloodstream infection differ between patient cohorts that have different clinical courses of infection

Sinead McNicholas et al. BMC Infect Dis. .

Abstract

Background: The clinical course of Staphylococcus aureus bloodstream infection is unpredictable and bacterial virulence, host immune response and patient characteristics are among the factors that contribute to the clinical course of infection. To investigate the relationship between cytokine response and clinical outcome, circulating cytokine levels were investigated in response to S. aureus bloodstream infection in patients with different clinical courses of infection.

Methods: A prospective study was carried out in 61 patients with S. aureus bloodstream infection and circulating levels of IL-6, GRO-γ, RANTES and leptin were assessed over the course of the infection. Levels were compared in patients with complicated courses of infection (e.g. infective endocarditis) versus uncomplicated courses of S. aureus bloodstream infection and methicillin-resistant S. aureus Vs methicillin-susceptible S. aureus infection.

Results: Significantly lower leptin levels (p < 0.05) and significantly higher IL-6 levels (p < 0.05) were detected at laboratory diagnosis in patients with complicated compared to uncomplicated S. aureus bloodstream infection. Significantly higher levels of GRO-γ were associated with MRSA infection compared to MSSA infection.

Conclusions: IL-6 may be an early inflammatory marker of complicated S. aureus bloodstream infection. Leptin may be protective against the development of a complicated S. aureus bloodstream infection.

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Figures

Figure 1
Figure 1
Analysis of differential cytokine levels in pooled plasma from patients with SABSI. The cytokine antibody array map (RayBiotech Inc., GA) showing the positions of 42 duplicate cytokines, positive and negative controls (A). Hybridization patterns for pooled plasma from three patients per group, comparing patients with complicated SABSI to patients with uncomplicated SABSI (B) and patients with MSSA to patients with MRSA (C). Arrows indicate cytokines selected for investigation in all patients (B and C) and were based on a fold change in levels of ≥1.4 between groups. Fold change was estimated from cytokine signal intensity from compared groups (uncomplicated/complicated, MSSA/MRSA) where signal intensity was normalised with respect to the signal intensity of six positive control spots on each membrane, located at positions A1, A2, B1, B2, L7, L8.
Figure 2
Figure 2
Scatter plot of the concentrations of four cytokines in all patient samples collected over the course of S. aureus BSI. Cytokine levels on the day of laboratory diagnosis and seven days after diagnosis of SABSI are shown (n = 61). Horizontal bars show the mean values for each cytokine.
Figure 3
Figure 3
Cytokine levels in patients with uncomplicated Vs complicated SABSI. Cytokine levels in plasma from patients with uncomplicated (clear bars, n = 50) and complicated (solid grey bars, n = 11) SABSI at diagnosis (day 0), day 7 and day 14. Data shown represent mean cytokine concentration ± SEM for IL-6 (A), GRO-γ (B), RANTES (C) and leptin (D). Dotted lines in each panel indicate the mean cytokine levels found in four healthy control individuals.
Figure 4
Figure 4
Scatter plot of GRO- γ levels in patients with SABSI caused by MRSA Vs SABSI caused by MSSA. GRO-γ levels in patients with MSSA (open circles, n = 46) or MRSA BSI (closed circles, n = 15) over the course of SABSI. Horizontal bars show the mean values for each cytokine.
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