TY - JOUR T1 - Blood leukocyte transcriptomes in gram-positive and gram-negative community-acquired pneumonia JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01856-2021 SP - 2101856 AU - Liza Pereverzeva AU - Fabrice Uhel AU - Hessel Peters Sengers AU - Joe Butler AU - Lonneke A. van Vught AU - Katie L. Burnham AU - Emma E. Davenport AU - Julian C. Knight AU - Olaf L. Cremer AU - Marcus J. Schultz AU - Marc M. J. Bonten AU - Brendon P. Scicluna AU - Tom van der Poll A2 - , Y1 - 2021/01/01 UR - http://erj.ersjournals.com/content/early/2021/07/29/13993003.01856-2021.abstract N2 - Background Gram-positive and Gram-negative bacteria are the most common causative pathogens in community-acquired pneumonia (CAP) on the intensive care unit (ICU). The aim of this study was to determine whether the host immune response differs between Gram-positive and Gram-negative CAP upon ICU admission.Methods Sixteen host response biomarkers providing insight in pathophysiological mechanisms implicated in sepsis and blood leukocyte transcriptomes were analysed in patients with CAP upon ICU admission in two tertiary hospitals in the Netherlands.Results 309 patients with CAP with a definite or probable likelihood (determined by predefined criteria) were included. A causative pathogen was determined in 74.4% of admissions. Patients admitted with Gram-positive CAP (n=90) were not different from those admitted with Gram-negative CAP (n=75) regarding demographics, chronic comorbidities, severity of disease and mortality. Host response biomarkers reflective of systemic inflammation, coagulation activation and endothelial cell function, as well as blood leukocytes transcriptomes, were largely similar between Gram-positive and Gram-negative CAP. Blood leukocyte transcriptomes were also similar in Gram-positive and Gram-negative CAP in two independent validation cohorts. On a pathogen-specific level, Streptococcus pneumoniae and Escherichia coli induced the most distinct host immune response.Conclusion Outcome and host response are similar in critically ill patients with CAP due to Gram-positive bacteria compared to Gram-negative bacteria.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Pereverzeva has nothing to disclose.Conflict of interest: Dr. Uhel has nothing to disclose.Conflict of interest: Dr. Peters Sengers reports grants from Dutch Kidney Foundation (Nierstichting), outside the submitted work.Conflict of interest: Dr. Butler has nothing to disclose.Conflict of interest: Dr. van Vught has nothing to disclose.Conflict of interest: Dr. Burnham has nothing to disclose.Conflict of interest: Dr. Davenport has nothing to disclose.Conflict of interest: Dr. Knight has nothing to disclose.Conflict of interest: Dr. Cremer has nothing to disclose.Conflict of interest: Dr. Schultz has nothing to disclose.Conflict of interest: Dr. Bonten has nothing to disclose.Conflict of interest: Dr. Scicluna has nothing to disclose.Conflict of interest: Dr. van der Poll has nothing to disclose. ER -