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Evaluation of the Diagnostic Performance of Interleukin-6, C-reactive Protein, and Soluble Triggering Receptor Expressed on Myeloid Cells−1, Individually and Combined, in Differentiating Candidemia from Bacteremia in Intensive Care Unit Patients

Year: 2025

Type: article

Abstract: Introduction: Differentiating candidemia from bacteremia in intensive care unit (ICU) patients is critical for effective treatment but is often delayed by reliance on conventional diagnostics like blood cultures. This study evaluates the diagnostic utility of interleukin-6 (IL-6), C-reactive protein (CRP), and soluble triggering receptor expressed on myeloid cells −1 (sTREM-1), individually and in combination, for distinguishing these bloodstream infections (BSIs). Methods: This prospective observational study included 74 ICU patients with BSIs admitted to a university-affiliated hospital between September 2023 and August 2024. Biomarker levels were measured on the 2 nd day of ICU admission. Diagnostic performance was assessed using the Mann–Whitney U test, logistic regression, and receiver operating characteristic curve analysis. Results: Of the 74 patients, 54 (72.9%) had bacteremia and 20 (27.1%) had candidemia. IL-6 and sTREM-1 levels were significantly higher in candidemia ( P < 0.001), whereas CRP alone did not show discriminatory power ( P = 0.981). The combined biomarker model achieved an area under the curve of 0.818, demonstrating superior diagnostic performance compared to individual markers. Conclusions: IL-6 and sTREM-1 are effective biomarkers for distinguishing candidemia from bacteremia, with CRP providing additional value in a multibiomarker model. This approach may enhance diagnostic precision and improve clinical decision-making in ICU settings.

Source: Journal of Global Infectious Diseases

DOI: 10.4103/jgid.jgid_12_25