PloS one · 2026
ICU-acquired infections and mortality in community-acquired pneumonia-induced sepsis: Insights from a transcriptomic analysis.
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Almuntashiri Sultan, Alsowaida Yazed S, Zhang Duo, Alghubayshi Ali, Alanazi Muteb, Alharby Tareq Nafea, Ansari Mukhtar
Аннотация
OBJECTIVES: To evaluate the association between ICU-acquired infections and 28-day mortality in pneumonia-induced sepsis and to explore associated immune-related gene expression patterns.
METHODS: A secondary analysis was performed using the publicly available GSE65682 dataset, including adult ICU patients with sepsis secondary to community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). Patients were stratified based on the development of ICU-acquired infections. 28-day mortality and whole-blood leukocyte gene expression at ICU admission were compared between groups.
RESULTS: Among 144 patients, 20 developed ICU-acquired infections. In the CAP subgroup, ICU-acquired infections were associated with numerically higher 28-day mortality compared to those without infection (45.5% vs. 18.2%, p = 0.05), although this finding should be interpreted with caution given the retrospective study design and limited sample size. In HAP patients, a similar pattern was not observed (22.2% vs. 19.6%). Transcriptomic analysis showed significant downregulation of the interleukin-7 receptor (IL7R) in CAP patients who developed ICU-acquired infections, with PRKACB and CD3D also demonstrating a downward trend.
CONCLUSION: These findings suggest that early immune dysregulation may be associated with an increased susceptibility to secondary infections and potentially worse outcomes among CAP patients. IL7R may represent a candidate signal of immune dysregulation and warrants further investigation and validation in future studies.
METHODS: A secondary analysis was performed using the publicly available GSE65682 dataset, including adult ICU patients with sepsis secondary to community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). Patients were stratified based on the development of ICU-acquired infections. 28-day mortality and whole-blood leukocyte gene expression at ICU admission were compared between groups.
RESULTS: Among 144 patients, 20 developed ICU-acquired infections. In the CAP subgroup, ICU-acquired infections were associated with numerically higher 28-day mortality compared to those without infection (45.5% vs. 18.2%, p = 0.05), although this finding should be interpreted with caution given the retrospective study design and limited sample size. In HAP patients, a similar pattern was not observed (22.2% vs. 19.6%). Transcriptomic analysis showed significant downregulation of the interleukin-7 receptor (IL7R) in CAP patients who developed ICU-acquired infections, with PRKACB and CD3D also demonstrating a downward trend.
CONCLUSION: These findings suggest that early immune dysregulation may be associated with an increased susceptibility to secondary infections and potentially worse outcomes among CAP patients. IL7R may represent a candidate signal of immune dysregulation and warrants further investigation and validation in future studies.