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Gene expression may identify burn patients at risk for repeat infections
Researchers have identified characteristics, including differences in gene expression, to identify patients with severe burns who are at highest risk for repeat infections, according to data published in Annals of Surgery.
“Our approach is the first to enable the prediction of repeat infections days or even weeks before they occur,” Laurence Rahme, MS, PhD, director of the Molecular Surgical Laboratory in the Massachusetts General Hospital Department of Surgery, said in a press release. “All current approaches that use biomarkers identify infections after they have occurred. The ability to predict infection would allow more effective prevention and treatment, help stop the emergence of antibiotic-resistant microorganisms and reduce the costs of care.”
Laurence Rahme
Rahme and colleagues conducted an analysis of 113 patients with 20% or more total body surface area burns. Sixty-six patients were considered the case group. They were classified as hypersusceptible to infections, because they had multiple episodes of infections. The remaining 47 patients were considered the control group because they all had one or fewer infections. All of the patients had gene expression data.
The researchers found that in addition to the current clinical factors linked to infection — patients’ age, the extent of burn injury and lung injury from smoke inhalation — a biomarker model observing differences in gene expression also predicted the infection susceptibility for more than 80% of the patients. Expression of genes that are involved in immune response, overall metabolism and epigenetic functions were significantly different between patients who experienced multiple infection episodes.
Infections are the leading cause of death among patients with severe burns, according to the researchers, and multiple infections affect a patient’s ability to heal. Rahme said these findings also are applicable to other groups of patients, such as military personnel, who often develop infections as a result of blast and combat injuries.
“These infections cause grave suffering, severe pain, emotional and physical stress, and considerable financial burdens to patients, their families and to health care systems,” Rahme said in the release. “With our focus on innovative ways to counter these infections through the development of biomarker panels and our pioneering work on anti-virulence therapies that block pathogenesis but not cell viability, we hope to open new avenues to treat and prevent infection that do not contribute to antibiotic resistance.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.