Species-Specific Immunoassay Aids Identification of Pathogen and Tracks Infectivity in Foot Infection.
Species-Specific Immunoassay Aids Identification of Pathogen and Tracks Infectivity in Foot Infection.
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种属特异性免疫测定有助于足部感染病原体的鉴定和追踪致病性。
DOI：
10.1177/1071100720965136
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发表时间：
2021-03
影响因子：
2.7
通讯作者：
Oh I
中科院分区：
文献类型：
--
作者：
Hao SP;Masters EA;Ninomiya MJ;Beck CA;Schwarz EM;Daiss JL;Oh I
传统培养常常无法识别多种微生物足部感染的主要病原体，其中金黄色葡萄球菌是最常见的感染病原体。先前的工作表明，物种特异性免疫分析可能能够识别肌肉骨骼感染的主要病原体。我们试图研究金黄色葡萄球菌免疫测定的临床适用性，以准确识别感染病原体并纵向监测其在足部感染中的感染性。我们假设这种物种特异性免疫测定可以 1) 帮助诊断金黄色葡萄球菌，2) 跟踪足部感染的治疗反应。 2015年7月至2019年7月，招募了83名接受外科手术（清创或截肢）的感染性足部溃疡患者，并在第0、4、8和12周时抽血。分析全血中金黄色葡萄球菌特异性血清抗体（历史抗体和新抗体的混合物），并分离和培养浆母细胞以量化新合成抗体（NSA）的滴度。抗S。将金黄色葡萄球菌抗体滴度与培养结果进行比较，以评估它们在将金黄色葡萄球菌鉴定为病原体方面的一致性。将随访时的 NSA 滴度变化与伤口愈合状态进行比较，以评估不断发展的宿主免疫反应与临床解决或复发感染之间的一致性。分析血清中的抗-S。金黄色葡萄球菌抗体显示 3 种不同的抗金黄色葡萄球菌抗体滴度显着增加。与培养阴性患者相比，金黄色葡萄球菌培养阳性患者的金黄色葡萄球菌抗体、IsdH (p = 0.037)、ClfB (p = 0.025) 和 SCIN (p = 0.005)。用于金黄色葡萄球菌感染诊断的组合抗原的比较分析进一步提高了一致性。在随访期间，针对单一或组合金黄色葡萄球菌抗原的 NSA 滴度变化与以伤口愈合状态为代表的临床消退或复发感染显着相关。总之，这种金黄色葡萄球菌免疫测定能够跟踪治疗反应并检测复发感染。在足部感染的治疗中，使用金黄色葡萄球菌特异性免疫测定可能有助于诊断主要病原体，并监测宿主针对治疗后针对特定病原体的免疫反应。重要的是，这种免疫分析可以检测复发性足部感染，这可以指导外科医生做出干预决定。诊断研究
Conventional culture frequently fails to identify the dominant pathogen in polymicrobial foot infections, in which Staphylococcus aureus is the most common infecting pathogen. Previous work has shown that species-specific immunoassays may be able to identify the main pathogen in musculoskeletal infections. We sought to investigate the clinical applicability of a S. aureus immunoassay to accurately identify the infecting pathogen and monitor its infectivity longitudinally in foot infection. We hypothesized that this species-specific immunoassay can 1) aid diagnosis of S. aureus and 2) track the therapeutic response in foot infections. From July 2015 to July 2019, 83 infected foot ulcer patients undergoing surgical intervention (debridement or amputation) were recruited and blood was drawn at 0, 4, 8 and 12 weeks. Whole blood was analyzed for S. aureus-specific serum antibodies (mix of historic and new antibodies) and plasmablasts were isolated and cultured to quantify titers of newly synthesized antibodies (NSA). Anti-S. aureus antibody titers were compared to culture results to assess their concordance in identifying S. aureus as the pathogen. The NSA titer changes at follow-ups were compared to wound healing status to evaluate concordance between evolving host immune response versus clinically resolving or relapsing infection. Analysis of serum for anti-S. aureus antibodies showed significantly increased titers of 3 different anti-S. aureus antibodies, IsdH (p = 0.037), ClfB (p = 0.025), and SCIN (p = 0.005) in S. aureus culture positive patients compared to culture negative patients. Comparative analysis of combining antigens for S. aureus infection diagnosis increased the concordance further. During follow-ups, changes of NSA titers against a single or combination of S. aureus antigens significantly correlated with clinically resolving or recurring infection represented by wound healing statuses. In summary, this S. aureus immunoassay was able to track treatment response and detect recurrent infection. In management of foot infection, the use of S. aureus-specific immunoassay may aid in diagnosis of the dominant pathogen and monitor the host immune response against a specific pathogen in response to treatment. Importantly, this immunoassay can detect recurrent foot infection which may guide a surgeon’s decision to intervene. Diagnostic Study
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影响因子：
3.1
作者：
Percival, Steven L.;Malone, Matthew;Schultz, Gregory
通讯作者：
Schultz, Gregory
影响因子：
5.5
作者：
Halliley, Jessica L.;Kyu, Shuya;Lee, F. Eun-Hyung
通讯作者：
Lee, F. Eun-Hyung
影响因子：
4.2
作者：
Nishitani, Kohei;Beck, Christopher A.;Daiss, John L.
通讯作者：
Daiss, John L.
影响因子：
11.8
作者：
Jeffcoate, WJ;Lipsky, BA
通讯作者：
Lipsky, BA
影响因子：
6.4
作者：
Berry, Irina Maljkovic;Melendrez, Melanie C.;Jarman, Richard G.
通讯作者：
Jarman, Richard G.