Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients

<b>Background:</b> Timely and accurate identification of bloodstream infections (BSIs) in intensive care unit (ICU) patients remains a key challenge, particularly in COVID-19 settings, where immune dysregulation can obscure early clinical signs. <b>Methods:</b> Cytokine profi...

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Main Authors: Rúben Araújo, Luís Ramalhete, Cristiana P. Von Rekowski, Tiago A. H. Fonseca, Cecília R. C. Calado, Luís Bento
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Metabolites
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Online Access:https://www.mdpi.com/2218-1989/15/3/204
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author Rúben Araújo
Luís Ramalhete
Cristiana P. Von Rekowski
Tiago A. H. Fonseca
Cecília R. C. Calado
Luís Bento
author_facet Rúben Araújo
Luís Ramalhete
Cristiana P. Von Rekowski
Tiago A. H. Fonseca
Cecília R. C. Calado
Luís Bento
author_sort Rúben Araújo
collection DOAJ
description <b>Background:</b> Timely and accurate identification of bloodstream infections (BSIs) in intensive care unit (ICU) patients remains a key challenge, particularly in COVID-19 settings, where immune dysregulation can obscure early clinical signs. <b>Methods:</b> Cytokine profiling was evaluated to discriminate between ICU patients with and without BSIs, and, among those with confirmed BSIs, to further stratify bacterial infections by Gram type. Serum samples from 45 ICU COVID-19 patients were analyzed using a 21-cytokine panel, with feature selection applied to identify candidate markers. <b>Results:</b> A machine learning workflow identified key features, achieving robust performance metrics with AUC values up to 0.97 for BSI classification and 0.98 for Gram typing. <b>Conclusions:</b> In contrast to traditional approaches that focus on individual cytokines or simple ratios, the present analysis employed programmatically generated ratios between pro-inflammatory and anti-inflammatory cytokines, refined through feature selection. Although further validation in larger and more diverse cohorts is warranted, these findings underscore the potential of advanced cytokine-based diagnostics to enhance precision medicine in infection management.
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spelling doaj-art-961ab9e11eb744ae83c7ca199dd5a76c2025-08-20T01:49:05ZengMDPI AGMetabolites2218-19892025-03-0115320410.3390/metabo15030204Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 PatientsRúben Araújo0Luís Ramalhete1Cristiana P. Von Rekowski2Tiago A. H. Fonseca3Cecília R. C. Calado4Luís Bento5NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, PortugalNMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, PortugalNMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, PortugalNMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, PortugalISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, PortugalNMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal<b>Background:</b> Timely and accurate identification of bloodstream infections (BSIs) in intensive care unit (ICU) patients remains a key challenge, particularly in COVID-19 settings, where immune dysregulation can obscure early clinical signs. <b>Methods:</b> Cytokine profiling was evaluated to discriminate between ICU patients with and without BSIs, and, among those with confirmed BSIs, to further stratify bacterial infections by Gram type. Serum samples from 45 ICU COVID-19 patients were analyzed using a 21-cytokine panel, with feature selection applied to identify candidate markers. <b>Results:</b> A machine learning workflow identified key features, achieving robust performance metrics with AUC values up to 0.97 for BSI classification and 0.98 for Gram typing. <b>Conclusions:</b> In contrast to traditional approaches that focus on individual cytokines or simple ratios, the present analysis employed programmatically generated ratios between pro-inflammatory and anti-inflammatory cytokines, refined through feature selection. Although further validation in larger and more diverse cohorts is warranted, these findings underscore the potential of advanced cytokine-based diagnostics to enhance precision medicine in infection management.https://www.mdpi.com/2218-1989/15/3/204cytokine profilingbloodstream infectionsGram typingICU diagnosticsCOVID-19machine learning
spellingShingle Rúben Araújo
Luís Ramalhete
Cristiana P. Von Rekowski
Tiago A. H. Fonseca
Cecília R. C. Calado
Luís Bento
Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
Metabolites
cytokine profiling
bloodstream infections
Gram typing
ICU diagnostics
COVID-19
machine learning
title Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
title_full Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
title_fullStr Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
title_full_unstemmed Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
title_short Cytokine-Based Insights into Bloodstream Infections and Bacterial Gram Typing in ICU COVID-19 Patients
title_sort cytokine based insights into bloodstream infections and bacterial gram typing in icu covid 19 patients
topic cytokine profiling
bloodstream infections
Gram typing
ICU diagnostics
COVID-19
machine learning
url https://www.mdpi.com/2218-1989/15/3/204
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