Plasma level of soluble urokinase-type plasminogen activator receptor as a prognostic marker of disease severity in Streptococcus dysgalactiae subspecies equisimilis bacteremia

Abstract Streptococcus dysgalactiae subspecies equisimilis (SDSE) causes severe bacteremic infections. Elevated soluble urokinase-type plasminogen activator receptor (suPAR) has been studied as a biomarker in several infectious conditions. We evaluated the association between suPAR levels, clinical characteristics and disease severity in SDSE bacteremia. Adult patients with a positive blood culture for SDSE in two hospitals in Tampere, Finland, between 11/2015 and 11/2019 were prospectively studied. Severe disease ( N = 15) was defined as intensive care unit treatment ( n = 10) and/or death ( n = 7). Plasma suPAR levels were quantified in 293 samples from 153 patients. The median of the first suPAR concentrations was 4.81 ng/mL. SuPAR concentrations were significantly higher in severe disease compared with non-severe disease (medians 8.03 ng/mL vs. 4.54 ng/mL). Patients with underlying chronic liver (10.7 ng/mL), cardiovascular (5.80 ng/mL) or kidney disease (6.89 ng/mL), and those with alcohol abuse (7.54 ng/mL) had elevated suPAR levels compared to those without such condition. Elevated suPAR levels were associated with pneumonia (6.15 ng/mL) and abscesses (7.43 ng/mL). High suPAR levels correlate with severe disease in SDSE bacteremia patients. SuPAR measurement could support early risk assessment and management of SDSE bacteremia patients.