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

• Published in: BMC infectious diseases 2021-10, Vol.21 (1), p.1046-1046, Article 1046
• Main Authors: Hedetoft, Morten, Hansen, Marco Bo, Madsen, Martin Bruun, Johansen, Julia Sidenius, Hyldegaard, Ole
• Format: Article
• Language: English
• Subjects: Accuracy; Acute phase proteins; Age; Bacterial diseases; Bacterial infections; Biochemistry; Biological markers; Biomarkers; Chitinase-3-Like Protein 1; Chitinase-3-like-1 protein; Clinical endpoint; Decision making; Fournier’s gangrene; Health aspects; Humans; Immune system; Infections; Infectious diseases; Infectious skin diseases; Inflammation; Mortality; Necrosis; Necrotizing fasciitis; Patient outcomes; Patients; Physiology; Plasma; Prognosis; Regression analysis; Sepsis; Septic shock; Severity of Illness Index; Sex; Shock, Septic; Soft Tissue Infections; Survival
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-06760-x

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. 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. Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p