1058. Prognostic Biomarkers for Persistent Bacteremia and Mortality in Complicated S. aureus Bloodstream Infection
Session: Poster Abstract Session: Bacteremia and Endocarditis
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Cao_IDweek.pdf (2.1 MB)
  • Background:

    Staphylococcus aureus is a leading cause of bacteremia, yet there remains a significant knowledge gap in the identification of relevant biomarkers that predict clinical outcomes in patients with S. aureus bacteremia. Heterogeneity in the host response to invasive S. aureus infection suggests that specific biomarker signatures could be utilized to differentiate patients prone to severe disease, thereby facilitating earlier implementation of more aggressive therapies. To further elucidate the inflammatory correlates of poor clinical outcomes in patients with S. aureus bacteremia, we evaluated the association between a panel of blood proteins at initial presentation of bacteremia and disease severity outcomes.

    Methods:

    We conducted an observational study (n=32) to evaluate the prognostic value of circulating protein biomarkers for mortality and persistent bacteremia in patients with S. aureus bloodstream infections. A case-control study of 124 patients with complicated confirmed S. aureus bloodstream infections was used to validate our findings in the observational study.

    Results:

    We identified 13 candidate proteins that were correlated with mortality and persistent bacteremia by multiple comparisons. Further statistical modeling identified IL-8 and CCL2 as the strongest individual predictors of mortality, with the combination of these biomarkers having the best power to classify fatal outcome. Baseline IL-17A levels were elevated in patients with persistent bacteremia, endovascular and metastatic tissue infections.

    Conclusion:

    The results demonstrate the potential utility of selected biomarkers to distinguish patients with the highest risk for treatment failure and bacteremia-related complications, providing a valuable tool for clinicians in the management of S. aureus bacteremia. Additionally, these biomarkers could identify patients with the greatest potential to benefit from novel therapies in clinical trials.

    Yi Cao, PhD1, Alessander Guimaraes, PhD2, Kyu Hong, PhD2, Oleg Mayba, phD2, Melicent Peck, MD, PhD3, Johnny Gutierrez, PhD2, Felicia Ruffin, MSN, RN4, Montserrat Carrasco-Triguero, PhD2, Jason Dinoso, PhD2, A Asa Clemenzi-Allen, MD5, Catherine Koss, PhD6, Stacey A. Maskarinec, MD, PhD7, Henry F. Chambers, MD8, Vance G. Fowler Jr., MD9, Amos Baruch, PhD10 and Carrie Rosenberger, PhD2, (1)Genentech Inc, South San Francisco, CA, (2)GENENTECH INC, South San Francisco, CA, (3)Genentech, Inc., South San Francisco, CA, (4)Division of Infectious Diseases, Duke University Medical Center, Durham, NC, (5)Division of HIV/AIDS, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, CA, (6)UCSF, San Francisco, CA, (7)Infectious Diseases, Duke University Medical Center, Durham, NC, (8)Clinical Research Services, University of California San Francisco, Clinical and Translational Sciences Institute, San Francisco, CA, (9)Duke University, Durham, NC, (10)Genentech, South San Francisco, CA

    Disclosures:

    Y. Cao, None

    A. Guimaraes, None

    K. Hong, None

    O. Mayba, None

    M. Peck, None

    J. Gutierrez, None

    F. Ruffin, None

    M. Carrasco-Triguero, None

    J. Dinoso, None

    A. A. Clemenzi-Allen, None

    C. Koss, None

    S. A. Maskarinec, None

    H. F. Chambers, None

    V. G. Fowler Jr., None

    A. Baruch, None

    C. Rosenberger, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.