Patients with febrile episodes and were identified as
bloodstream infections through blood culture were enrolled, while healthy people were included as control group. Fourteen serum
cytokine and
chemokine levels were detected with multiplex platform. ROC analysis was performed and an area under the curve (AUC), sensitivity and specificity values were calculated to determine the efficacy of various
cytokines and
chemokines for
candidemia and
bacteremia. Binary logistic regression was performed to further explore the combination mode of
cytokines and
chemokines, which could increase the diagnostic efficiency.
RESULTS: We included 40 patients with an episode of microbiologically proven
fungal infection, 175 patients with
bacteremia (85 with Gram-positive
bacteremia and 90 with Gram-negative
bacteremia) and another 30 healthy controls. Routine laboratory parameters including CRP and PCT were not statistically significant between
candidemia group and
bacteremia group (both gram-positive and gram-negative). There were significantly higher levels of IFN-γ, TNF-α,
IL-10 and lower levels of
IL-3,
IL-4 in
candidemia group, compared with gram-positive and gram-negative
bacteremia groups.
G-CSF was significantly lower and MIP-1β was higher in
candidemia group, when compared with gram-negative
bacteremia group. While
IL-6,
IL-8 and
IL-17 were all significantly higher in
candidemia group, when compared with gram-positive
bacteremia group. Combination of IFN-γ and
IL-17 could improve the diagnostic efficiency between
candidemia and gram-positive
bacteremia, with the AUROC of 0.873 (95% CI: 0.767-0.929). While combination of
G-CSF and MIP-1β improved the diagnostic efficiency between
candidemia and gram-negative
bacteremia, with the AUROC of 0.896 (95% CI: 0.792-0.939).
CONCLUSION: