Serum Cytokine Profile in Patients with Candidemia versus Bacteremia.

Saad J Taj-Aldeen,Fayaz Ahmad Mir,Siveen K Sivaraman,Atqah Abdulwahab

doi:10.3390/pathogens10101349

Saad J Taj-Aldeen, Fayaz Ahmad Mir + Show 2 more

Open Access

https://doi.org/10.3390/pathogens10101349

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Abstract

Bloodstream Candida infections constitute a major threat for hospitalized patients in intensive care units and immunocompromised hosts. Certain serum cytokines play a decisive role in anti-microbial host defense. Cytokines may act as discriminatory biomarkers that can significantly increase in candidemia compared to bacteremia patients. The concentration of secreted cytokine/chemokines was determined using a multiplexed cytometric bead array run on a cell analyzer. The cytokines tested during the study were interleukin (IL)-1β, IL-6, IL-17A, IL-10, IFN-γ, IL-4, IL-2, IL-8, IL-12p70 and the tumor necrosis factor (TNF)-α. The cytokines of 51 candidemia patients were characterized and compared to the cytokine levels of 20 bacteremia patients. Levels were significantly elevated in patients with bloodstream infections compared to healthy controls. Cytokines comprising IL-2, IL-17A, IL-6 and IL-10 were significantly elevated in the patients with bloodstream Candida infection as compared to the patients having bloodstream bacterial infections. The levels were found to be promising as a potential diagnostic marker for bloodstream Candida infections.

Highlights

The incidence of candidemia has increased dramatically, including the infections documented in intensive care units (ICUs)
We analyzed clinical information pertaining to bloodstream infections (BSIs) from 71 (51 candidemia and 20 bacteremia) patients hospitalized in all clinical departments of Hamad Medical Corporation (HMC), including the intensive care units (ICUs), hematology/oncology department and other medical and surgical wards
Our results show that cytokines IL-8, IFN-γ, tumor necrosis factor (TNF)-α and IL-2 were significantly elevated in the candidemia, compared to the control healthy group (Figure 1)

Summary

Introduction

The incidence of candidemia has increased dramatically, including the infections documented in intensive care units (ICUs). 53% of documented candidemia in Hamad hospital, Qatar, was from the ICUs [1]. Candida spp. are the third most common microorganisms responsible for health-care-related bloodstream infections [2]. Blood cultures for yeasts lack sensitivity and need prolonged incubation (> 48 h) to generate positive results. Antifungal drugs are often prescribed either prophylactically, preemptively, or empirically in high-risk patients [3]. The resulting overuse of antifungal drugs may lead to the emergence of Candida species that are resistant to azoles and/or echinocandins [4,5]

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