Assessing the Diagnostic Accuracy of Soluble Urokinase Plasminogen Activator Receptor and Lipoteichoic Acid Biomarkers in Gram-Positive Bacterial Pathogen for Timely Detection and Differentiation of Colonization versus Active Infection

Mohammed Sadeq Khalife; Sawsan M. Jabbar Al-Hasnawi; May Mohammed Ali

doi:10.4167/jbv.2025.55.3.222

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2025 Vol.55, Issue 3 Preview Page Next Page

Original Article

Assessing the Diagnostic Accuracy of Soluble Urokinase Plasminogen Activator Receptor and Lipoteichoic Acid Biomarkers in Gram-Positive Bacterial Pathogen for Timely Detection and Differentiation of Colonization versus Active Infection

30 September 2025. pp. 222-234

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Abstract

Gram-positive bacteria commonly cause bloodstream and other infections in hospitalized patients, with an increasing proportion of infections associated with antibiotic-resistant bacteria. Existing diagnostic methods have several limitations, such as delayed turnaround time and difficulty in distinguishing between bacterial colonization and active infection. Timely detection and appropriate antibiotic treatment are crucial for reducing morbidity and mortality. This study investigated the diagnostic potential of combining lipoteichoic acid (LTA), a molecule specific to Gram-positive bacteria, with soluble urokinase plasminogen activator receptor (suPAR), a biomarker with prognostic significance. The study aimed to develop a faster and more accurate method for diagnosing infections and differentiating colonization from active infection. A case–control study was conducted using serum samples from 62 patients with clinically diagnosed bacterial infections and from 38 healthy controls. Bacterial pathogens and antimicrobial susceptibility profiles were identified using standard laboratory procedures and the VITEK2 automated system. The participants’ serum suPAR and LTA levels were measured via ELISA. Analysis of variance was employed for group comparisons (p < 0.05), whereas receiver operating characteristic curve analysis was used to evaluate the sensitivity, specificity, and accuracy of the diagnostic metrics. Significant differences were observed in the LTA and suPAR levels (p = 0.0002 and p = 0.0007, respectively) between the infected patients and healthy controls. The area under the curve values were 99.57% and 99.41% for suPAR and LTA, respectively, indicating strong diagnostic accuracy. The sensitivity was 98.39% for suPAR and 95.16% for LTA, with corresponding specificity of 93.33% and 96.67%. These findings suggest that suPAR and LTA are promising biomarkers for the rapid diagnosis of Gram-positive bacterial infections, facilitating timely and appropriate treatment.

Keywords

Gram-positive bacteria

Lipoteichoic acid

Soluble urokinase plasminogen activator receptor

Biomarker

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Information

Publisher :The Korean Society for Microbiology and The Korean Society of Virology
Publisher(Ko) :대한미생물학회‧대한바이러스학회
Journal Title :JOURNAL OF BACTERIOLOGY AND VIROLOGY
Volume : 55
No :3
Pages :222-234
Received Date : 2025-03-24
Revised Date : 2025-06-02
Accepted Date : 2025-06-18
DOI :https://doi.org/10.4167/jbv.2025.55.3.222

JOURNAL OF BACTERIOLOGY AND VIROLOGY ISSN:1598-2467(Print) 2093-0429(Online)

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