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Multicenter Study
. 2023 Apr:249:109276.
doi: 10.1016/j.clim.2023.109276. Epub 2023 Mar 5.

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

Eivind Rath  1 , Laura M Palma Medina  2 , Sanjeevan Jahagirdar  3 , Knut A Mosevoll  4 , Jan K Damås  5 , Martin B Madsen  6 , Mattias Svensson  2 , Ole Hyldegaard  7 , Vitor A P Martins Dos Santos  8 ; INFECT Study group; Edoardo Saccenti  3 , Anna Norrby-Teglund  2 , Steinar Skrede  4 , Trond Bruun  4
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Free article
Multicenter Study

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

Eivind Rath et al. Clin Immunol. 2023 Apr.
Free article

Abstract

Objective: Early stages with streptococcal necrotizing soft tissue infections (NSTIs) are often difficult to discern from cellulitis. Increased insight into inflammatory responses in streptococcal disease may guide correct interventions and discovery of novel diagnostic targets.

Methods: Plasma levels of 37 mediators, leucocytes and CRP from 102 patients with β-hemolytic streptococcal NSTI derived from a prospective Scandinavian multicentre study were compared to those of 23 cases of streptococcal cellulitis. Hierarchical cluster analyses were also performed.

Results: Differences in mediator levels between NSTI and cellulitis cases were revealed, in particular for IL-1β, TNFα and CXCL8 (AUC >0.90). Across streptococcal NSTI etiologies, eight biomarkers separated cases with septic shock from those without, and four mediators predicted a severe outcome.

Conclusion: Several inflammatory mediators and wider profiles were identified as potential biomarkers of NSTI. Associations of biomarker levels to type of infection and outcomes may be utilized to improve patient care and outcomes.

Keywords: Biomarker; Cellulitis; NSTI; Necrotizing fasciitis; Streptococcus dysgalactiae; Streptococcus pyogenes.

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Conflict of interest statement

Declaration of Competing Interest All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and no potential conflicts are reported. Some of the data were presented at a lecture at the 21st Lancefield International Symposium for Streptococci and Streptococcal Diseases 2022, 7th - 10th June.

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