Trajectory of Serum IRF5 Changes During the Treatment of Carbapenem-Resistant Klebsiella Pneumoniae Infection and Its Correlation with Disease Progression

SONG Peiran; QI Hongshuang; ZHANG Weina; ZHANG Xin; DING Yanhua

doi:10.3969/j.issn.1004-437X.2026.07.014

Abstract：Objective To investigate the trajectory of serum interferon regulatory factor 5(IRF5)changes during the treatment of carbapenem-resistant Klebsiella pneumoniae(CRKP)infections and its correlation with disease progression.Methods A total of 105 patients with CRKP infection admitted to Nanyang Nanshi Hospital from September 2021 to June 2023 were selected.Serum IRF5 levels were measured before treatment,after 3 days of treatment,and after 5 days of treatment.The latent class trajectory model(LCTM)was used to establish a model of the trajectory of serum IRF5 levels during the CRKP infection treatment course.Based on the optimal model obtained,the patients were divided into three groups.The changes in serum IRF5 levels,baseline data,and incidence of disease progression were compared among the three groups.Cox regression analysis was used to investigate the impact of the trajectory of serum IRF5 levels during the CRKP infection treatment course on disease progression.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to evaluate the predictive efficiency of the trajectory of serum IRF5 levels during the CRKP infection treatment course for disease progression.Results The serum IRF5 levels before treatment,after 3 days of treatment,and after 5 days of treatment were(51.25±10.48)ng·L-1,(30.83±8.67)ng·L-1,and(22.51±6.43)ng·L-1,respectively,showing a continuous decreasing trend(P＜0.05).The optimal models obtained by LCTM were group T1(low-rapid decrease group),group T2(moderate-low-rapid decrease group),and group T3(high-slow decrease group).The pneumonia severity index(PSI)scores for patients in group T1,group T2,and group T3 were(75.48±7.36)scores,(82.20±6.48)scores,and(88.64±9.77)scores,respectively.The incidence rates of disease progression were 2.70％,5.88％,and 54.55％,respectively.The PSI scores and incidence rates of disease progression in group T1 were＜group T2＜group T3(P＜0.05).After adjusting for PSI scores,compared with group T1,Cox regression analysis showed the risks of disease progression in group T2 and group T3 increased by 1.208 times and 3.389 times,respectively(P＜0.05).When serum IRF5 levels showed a high-slow decrease trend,the AUC for predicting disease progression was 0.839,with sensitivity and specificity of 85.71％and 82.14％,respectively.Conclusion During the treatment course for CRKP infection,serum IRF5 levels tend to decrease,and a high-to-slow decrease in IRF5 levels can increase the risk of disease progression in patients.It has good predictive efficiency in assessing patient disease progression.