Clostridioides difficile infection (CDI) is associated with a high risk for complications and death, which requires identifying severe patients and treating them accordingly. We examined the serum level of six cytokines and chemokines (IL-16, IL-21, IL-23, IL-33, BCA-1, TRAIL) and investigated the association between them and patients’ disease severity. Concentrations of six cytokines and chemokines were measured using the MILLIPLEX®MAP kit (Billerica, MA, USA) in serum samples attained from CDI patients within 24–48 h after laboratory confirmation of C. difficile presence. Demographic and clinical data were collected from medical records. The disease severity score was determined according to guidelines of the “Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America” (SHEA-IDSA). Out of 54 patients, 20 (37%) had mild to moderate disease and 34 (63%) had severe disease. IL-16 (p = 0.005) and BCA-1 (p = 0.012) were associated with a more severe disease. In conclusion, IL-16 and BCA-1, along with other cytokines and chemokines, may serve as biomarkers for the early prediction of CDI severity in the future. An improved and more accessible assessment of CDI severity will contribute to the adjustment of the medical treatment, which will lead to a better patient outcome.
Background: Clostridioides difficile infection (CDI) have a high risk for complications up to death which requires identifying patients with severe disease and treating them accordingly. We examined the serum level of 6 cytokines and chemokines (IL-6, IL-21, IL-23, IL-33, BCA-1, TRAIL) and we checked the correlation between them to the patients' clinical characteristics and the bacterial strain.Methods: Concentrations of 6 cytokines and chemokines were measured using the MILLIPLEX®MAP kit (Billerica, USA) based on the Luminex xMAP® technology, in serum samples, attained from 54 CDI patients within a median time of 24-48 hours after laboratory confirmation of C. difficile presence. The demographic and clinical data were retrospectively collected from medical records. Disease severity score was determined according to the guidelines of the "Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America" (SHEA-IDSA).Results: Out of 54 patients (mean age, 76.6 years, 61.1% female), 20 (37%) had mild to moderate disease and 34 (63%) had severe disease. Two immunological markers were associated with a more severe disease: IL-16 (p = 0.005) and BCA-1 (p = 0.012). The study didn’t show a correlation between the immunological markers to the gender, the type of toxin which produced by the bacteria, in hospital mortality and infection acquisition.Conclusions: cytokines and chemokines may serve as a biomarker for early prediction of CDI severity in the future. Improved and more accessible assessment of CDI severity will contribute to adjustment of the medical treatment which will lead to a better patient outcome and hopefully will reduce the patient's mortality.
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