Abstract:

Objective To investigate changes and clinical significance of serum cytokine signaling inhibitor-1 (SOCS-1), soluble myeloid triggering receptor-2 (sTREM-2) and ATP citrate lyase (ACLY) in patients with pulmonary Klebsiella pneumoniae infection. Methods A total of 100 patients infected with Klebsiella pneumoniae were selected as the infection group, and 70 healthy subjects in our hospital were selected as the control group. According to the pneumonia severity index (PSI) score, patients of the infection group were divided into the severe group (PSI>90, 32 cases) and the mild group (PSI≤90, 68 cases). The expression levels of SOCS-1, sTREM-2 and ACLY in the infection group and the control group were detected by enzyme-linked immunosorbent assay. Pearson method was used to analyze the relationship between serum levels of SOCS-1, sTREM-2, ACLY and PSI scores in the infection group. Multivariate Logistic regression analysis was performed to analyze factors affecting the disease status of patients with pulmonary Klebsiella pneumoniae infection. The diagnostic value of serum levels of SOCS-1, sTREM-2 and ACLY in patients with Klebsiella pneumoniae infection was analyzed by receiver operating characteristic curve (ROC). Results The levels of white blood cell (WBC) count, procalcitonin (PCT), C-reactive protein (CRP), serum SOCS-1, sTREM-2 and ACLY were higher in the infection group than those in the control group (P<0.01). In infection group, serum levels of SOCS-1, sTREM-2 and ACLY were positively correlated with PSI scores (r=0.419, 0.373, 0.391, P<0.05). Serum levels of SOCS-1, sTREM-2 and ACLY were higher in the severe group than those in the mild group (P<0.01). The elevated serum SOCS-1, sTREM-2 and ACLY were risk factors for severe disease in patients with pulmonary Klebsiella pneumoniae infection (P<0.05). The areas under the curve (AUC) of SOCS-1, sTREM-2 and ACLY alone and in combination for the diagnosis of severe pulmonary Klebsiella pneumoniae infection were 0.787, 0.837, 0.847 and 0.929, respectively, and the combined diagnostic efficiency was the highest. Conclusion Serum SOCS-1, sTREM-2 and ACLY are elevated in patients with pulmonary Klebsiella pneumoniae infection, and their expression levels are related to the condition of patients with pulmonary Klebsiella pneumoniae infection. The combined detection of the three is better than testing alone for severe pulmonary Klebsiella pneumoniae infection.

Key words: pneumonia, Klebsiella pneumoniae, suppressor of cytokine signaling 1 protein, ATP citrate (pro-S)-lyase, triggering receptor expressed on myeloid cells 2