The Early Predictive Value of Cytokines in Bloodstream Infections
Objective To explore the early application value of 12 cytokines in bacterial bloodstream infections(BSI).Methods We collected specimens from all blood culture-positive patients at Beijing Tsinghua Changgung Hospital from May,2023 to January,2024 for the current study.Matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF MS)technique and VITEK 2 bacterial identification card were used to identify the bacterial species causing bloodstream infections.After screening process based on defined inclusion and exclusion criteria,a total of 55 patients with Gram-negative bacteria(GN-BSI)and 46 patients with Gram-positive bacteria(GP-BSI)were enrolled for the study.The concentrations of 12 cytokines in the plasma of patients with GN-BSI and GP-BSI were detected using cytometry bead array(CBA)method of Beckman Cytokines that showed significant variations in identifying G-and G+bacteria selected.The diagnostic efficacy of different cytokines and combinations in identifying G-and G+bacteria was evaluate and compared using receiver operating characteristic(ROC)curves by obtaining the optimal cut-off values,sensitivity,and specificity.Results Plasma concentrations of IL-6,IL-8,IL-10,IL-17,TNF-α,and IFN-α were significantly up-regulated in GN-BSI(P＜0.05).The area under the curve(AUC)of IL-6 was 0.796,with an optimal cut-off value of 115.29 pg/mL,sensitivity of 72.7％,and specificity of 82.6％.AUC of IL-8 was 0.670,with an optimal cut-off value of 55.75pg/mL,sensitivity of 85.5％,and specificity of 50.0％.AUC 0f IL-10 was 0.715,with an optimal cut-off value of 33.62 pg/mL,sensitivity of 52.7％,and specificity of 84.8％.AUC of IL-17 was 0.561,with an optimal cut-off value of 2.41 pg/mL,sensitivity of 70.9％,and specificity of 67.0％.AUC of TNF-α was 0.716,with an optimal cut-off value of 1.75 pg/mL,sensitivity of 49.1％,and specificity of 78.3％.AUC of IFN-α was 0.641,with an optimal cut-off value of 1.79pg/mL,sensitivity of 58.2％,and specificity of 83.6％.AUC of the combined detection of IL-6,IL-8,IL-10,IL-17,TNF-α,and IFN-α in identifying G-and G+bacterial infections was 0.817,with a sensitivity of 63.6％and specificity of 89.1％,which showed a better diagnostic efficacy than individual cytokine-based tests.Conclusion Cytokines combination model can assist in the early guiding value for the bacterial type of blood flow infection,providing a reference basis for the early selection of antibiotics in clinical practices.
万方数据
维普
