Poster Presentation Lancefield International Symposium for Streptococci and Streptococcal Diseases 2025

Transcriptomic predictors of delayed mortality in patients with invasive group A streptococcal disease (#231)

Ville Kailankangas 1 , Shintaro Katayama 2 , Kirsi Gröndahl-Yli-Hannuksela 3 , Johanna Vilhonen 4 , Mari H Tervaniemi 2 , Kaisu Rantakokko-Jalava 5 , Tapio Seiskari 6 , Emilia Lönnqvist 3 , Juha Kere 2 7 , Jarmo Oksi 4 , Jaana Syrjänen 1 , Jaana Vuopio 3
  1. Tampere University Hospital, Tampere, PIRKANMAA, Finland
  2. Folkhälsan Research Center, Helsinki, Finland
  3. Institute of Biomedicine, Turku, Finland
  4. Infectious Diseases, Turku University Hospital, Turku, Southwest Finland, Finland
  5. Clinical Microbiology, Turku University Hospital, Turku, Finland
  6. Clinical Microbiology, Tampere University Hospital, Tampere, Finland
  7. Department of Medicine Huddinge, Karolinska Institutet, Huddinge, Sweden

Background

Our aim was to study the pathophysiological mechanisms of early (<7 days) and delayed sepsis mortality by transcriptome profiling of cases with invasive group A Streptococcal (iGAS) infections and possibly find predictors for delayed mortality.  

Methods

We recruited iGAS cases from June 2018 to July 2020. Whole blood samples for transcriptome analysis and standard clinical laboratory tests were collected at the early timepoint (within two days after admission, timepoint A) and later timepoint (a week later, timepoint B). Gene expression was compared against disease course using weighted genome correlation network analysis.

Results

Forty-five patients were enrolled. After disqualifying degraded or impure RNAs we had 34 and 31 subjects at timepoints A and B, respectively. The gene expression profiles associated with a severe disease course differed markedly between timepoints A and B. High expression of necroptosis factors and low expression of HLA genes at timepoint B was associated with death.

Conclusions

The markedly different gene expression profile over time among patients with a severe iGAS disease may suggest distinct pathophysiological mechanisms for early and delayed sepsis mortality. The gene expression profile appears to predict delayed death better than CRP level.