{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:40:47Z","timestamp":1792510847312,"version":"4.5.0"},"reference-count":54,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100021856","name":"Ministero dell'Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["PRIN PNRR 2022 (Prot P2022M457Z)"],"award-info":[{"award-number":["PRIN PNRR 2022 (Prot P2022M457Z)"]}],"id":[{"id":"10.13039\/501100021856","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Sepsis caused by Gram-negative bloodstream infection is characterized by dynamic host responses, but the longitudinal and incremental prognostic value of calprotectin remains uncertain. We conducted a multicenter retrospective observational study of 82 adults with Gram-negative bloodstream infection, sepsis, and acute respiratory failure. Serum calprotectin, routine biomarkers, cytokines, and growth factors were measured at diagnosis before antibiotic therapy (T0), day 3 (T1), and day 7 (T2), and compared according to 28-day survival. Sixty-four patients survived, and 18 died. Calprotectin declined over time but remained higher in non-survivors at T0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), T1 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037), and T2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035); its longitudinal trajectory did not differ between survivors and non-survivors (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.408). Selected routine and immune biomarkers showed nominal differences at T2, but none of the 63 secondary biomarker-by-time comparisons remained significant after false-discovery-rate correction. Sequential organ failure assessment 2 (SOFA-2) alone strongly discriminated mortality (area under the receiver operating characteristic curve [AUC], 0.897; 95% CI, 0.828\u20130.965) and outperformed baseline calprotectin (AUC, 0.728; DeLong\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.027). Baseline calprotectin remained independently associated with mortality after adjustment for age and SOFA-2 (OR, 2.07 per doubling; 95% CI, 1.14\u20134.20;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018), but its addition yielded only a modest, non-significant improvement in discrimination (\u0394AUC, 0.023;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.117). SOFA-2 was the dominant prognostic discriminator; calprotectin may provide complementary rather than standalone prognostic information and requires external validation.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>Gram-negative bloodstream infection accompanied by acute respiratory failure carries a substantial risk of death. In this cohort, sequential organ failure assessment 2 (SOFA-2) was the strongest early predictor of 28-day mortality. Calprotectin was higher in non-survivors from diagnosis through day 7 and remained associated with mortality after adjustment for age and SOFA-2, but adding it to the clinical model produced only a modest and statistically non-significant improvement in discrimination. Other routine and immune biomarkers showed nominal late differences that did not remain significant after false-discovery-rate correction. These findings suggest that calprotectin may complement, but should not replace, established clinical severity assessment. Larger prospective cohorts with external validation are required before calprotectin or multimarker panels can be used for clinical risk stratification.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01767-26","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:00:37Z","timestamp":1789477237000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal and adjusted prognostic assessment of calprotectin in Gram-negative sepsis with acute respiratory failure"],"prefix":"10.1128","volume":"14","author":[{"given":"Simona","family":"Gigliotti","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0530bdk91","id-type":"ROR","asserted-by":"publisher"}],"name":"Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Manno","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0530bdk91","id-type":"ROR","asserted-by":"publisher"}],"name":"Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Colosimo","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, R. 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