scholarly journals The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection

2016 ◽  
Vol 8 (5) ◽  
pp. 507-516 ◽  
Author(s):  
Marco B. Hansen ◽  
Lars S. Rasmussen ◽  
Katrine Pilely ◽  
Dorthe Hellemann ◽  
Estrid Hein ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Confidence Interval ◽  
Soft Tissue Infection ◽  
Simplified Acute Physiology Score ◽  
Hazard Ratio ◽  
Tissue Infection ◽  
Complement Pathway ◽  
Necrotizing Soft Tissue Infection ◽  
Short And Long Term

Background: Mannose-binding lectin (MBL) and ficolins are pattern recognition molecules (PRMs) that play an important role during infection through activation of the lectin complement pathway. We assessed whether plasma PRM levels were associated with mortality in patients with necrotizing soft tissue infection (NSTI). Methods: We conducted a prospective, observational study over 25 months involving 135 NSTI patients with a maximum follow-up of 2.7 years. Blood samples were taken upon admission. Non-infected patients served as controls. Results: PRM levels were significantly lower compared with controls. A baseline Ficolin-2 level below the median was associated with mortality at the end of follow-up (p = 0.007). No significant association was found for MBL, Ficolin-1 and Ficolin-3. A Ficolin-2 level below the median had a negative predictive value of 0.94 for 28-day mortality, and a level below the optimal cut-off was independently associated with 28-day mortality when adjusted for age, sex and chronicity [hazard ratio 6.27 (95% confidence interval 2.28-17.21), p < 0.0001], also when Simplified Acute Physiology Score II was included in the analysis [hazard ratio 3.16 (95% confidence interval 1.03-9.73), p = 0.045]. Conclusions: All PRMs were significantly lower in patients with NSTI than in controls. Only baseline Ficolin-2 was associated with short- and long-term mortality. A high baseline Ficolin-2 level indicated a 94% chance of surviving the first 28 days after admission.

scholarly journals Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morten Hedetoft ◽  
Marco Bo Hansen ◽  
Martin Bruun Madsen ◽  
Julia Sidenius Johansen ◽  
Ole Hyldegaard
Keyword(s):  
Renal Replacement Therapy ◽  
Soft Tissue ◽  
Replacement Therapy ◽  
Disease Severity ◽  
Soft Tissue Infection ◽  
Simplified Acute Physiology Score ◽  
Tissue Infection ◽  
Acute Physiology Score ◽  
Necrotizing Soft Tissue Infection ◽  
Risk Of Death

Abstract Background Necrotizing soft-tissue infection (NSTI) is a severe and fast-progressing bacterial infection. Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown. For this purpose, we investigated the association between plasma YKL-40 and 30-day mortality in patients with NSTI, and assessed its value as a marker of disease severity. Methods We determined plasma YKL-40 levels in patients with NSTI (n = 161) and age-sex matched controls (n = 65) upon admission and at day 1, 2 and 3. Results Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p < 0.001). YKL-40 was found to be significantly higher in patients with septic shock (1942 vs. 720 ng/mL, p < 0.001), and in patients receiving renal-replacement therapy (2382 vs. 1041 ng/mL, p < 0.001). YKL-40 correlated with Simplified Acute Physiology Score II (Rho 0.33, p < 0.001). Baseline YKL-40 above 1840 ng/mL was associated with increased risk of 30-day mortality in age-sex-comorbidity adjusted analysis (OR 3.77, 95% CI; 1.59–9.24, p = 0.003), but after further adjustment for Simplified Acute Physiology Score II no association was found between YKL-40 and early mortality. Conclusion High plasma YKL-40 to be associated with disease severity, renal-replacement therapy and risk of death in patients with NSTI. However, YKL-40 is not an independent predictor of 30-day mortality.

Group G Streptococcal Necrotizing Soft Tissue Infection

2016 ◽  
Vol 78 (6) ◽  
pp. 644-649
Author(s):  
Eriko MAEHARA ◽  
Gaku TSUJI ◽  
Yukihiro MIZOTE ◽  
Naohide TAKEUCHI ◽  
Masutaka FURUE
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Necrotizing Soft Tissue Infection

Can Paronychia Cause a Remote Necrotizing Soft Tissue Infection?

2011 ◽  
Vol 40 (1) ◽  
pp. e11-e13 ◽  
Author(s):  
Julian E. Losanoff ◽  
Anne E. Missavage ◽  
Paul Linneman ◽  
Boyd E. Terry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Necrotizing Soft Tissue Infection

scholarly journals Hyperbaric oxygen treatment impacts oxidative stress markers in patients with necrotizing soft-tissue infection

2021 ◽  
pp. jim-2021-001837
Author(s):  
Morten Hedetoft ◽  
Peter Østrup Jensen ◽  
Claus Moser ◽  
Julie Vinkel ◽  
Ole Hyldegaard
Keyword(s):  
Oxidative Stress ◽  
Septic Shock ◽  
Soft Tissue ◽  
Hyperbaric Oxygen ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Heme Oxygenase 1 ◽  
Necrotizing Soft Tissue Infection ◽  
Before And After ◽  
Nitrite Nitrate

Necrotizing soft-tissue infection (NSTI) is a rare, severe, and fast-progressing bacterial infection associated with a high risk of developing sepsis or septic shock. Increasing evidence indicates that oxidative stress is crucial in the development and progression of sepsis, but its role in NSTI specifically has not been investigated. Some patients with NSTI receive hyperbaric oxygen (HBO2) treatment as the restoration of oxidative stress balance is considered an important mechanism of action, which HBO2 facilitates. However, a gap in knowledge exists regarding the effect of HBO2 treatment on oxidative stress in patients with NSTI. In the present observational study, we aimed to investigate HBO2 treatment effects on known markers of oxidative stress in patients with NSTI. We measured plasma myeloperoxidase (MPO), superoxide dismutase (SOD), heme oxygenase-1 (HO-1) and nitrite+nitrate in 80 patients with NSTI immediately before and after their first HBO2 treatment, and on the following day. We found that HBO2 treatment was associated with a significant increase in MPO and SOD by a median of 3.4 and 8.8 ng/mL, respectively. Moreover, we observed an HBO2 treatment-associated increase in HO-1 in patients presenting with septic shock (n=39) by a median of 301.3 pg/mL. All markers were significantly higher in patients presenting with septic shock compared to patients without shock, and all markers correlated with disease severity. High baseline SOD was associated with 90-day mortality. In conclusion, HBO2 treatment was associated with an increase in MPO and SOD in patients with NSTI, and oxidative stress was more pronounced in patients with septic shock.

scholarly journals A case of Apophysomyces trapeziformis necrotizing soft tissue infection

2013 ◽  
Vol 17 (12) ◽  
pp. e1240-e1242 ◽  
Author(s):  
Jose F. Echaiz ◽  
Carey-Ann D. Burnham ◽  
Thomas C. Bailey
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Necrotizing Soft Tissue Infection

scholarly journals A case of necrotizing soft-tissue infection caused by Citrobacter koseri

2009 ◽  
Vol 20 (1) ◽  
pp. 37-41
Author(s):  
Kyohei Miyamoto ◽  
Madoka Hiramatsu ◽  
Takahiro Ashikawa ◽  
Maki Shinozaki ◽  
Yukihiro Shima ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Necrotizing Soft Tissue Infection
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