A comparison of host response strategies to distinguish bacterial and viral infection.
PLoS One
; 16(12): e0261385, 2021.
Article
em En
| MEDLINE
| ID: mdl-34905580
ABSTRACT
OBJECTIVES:
Compare three host response strategies to distinguish bacterial and viral etiologies of acute respiratory illness (ARI).METHODS:
In this observational cohort study, procalcitonin, a 3-protein panel (CRP, IP-10, TRAIL), and a host gene expression mRNA panel were measured in 286 subjects with ARI from four emergency departments. Multinomial logistic regression and leave-one-out cross validation were used to evaluate the protein and mRNA tests.RESULTS:
The mRNA panel performed better than alternative strategies to identify bacterial infection AUC 0.93 vs. 0.83 for the protein panel and 0.84 for procalcitonin (P<0.02 for each comparison). This corresponded to a sensitivity and specificity of 92% and 83% for the mRNA panel, 81% and 73% for the protein panel, and 68% and 87% for procalcitonin, respectively. A model utilizing all three strategies was the same as mRNA alone. For the diagnosis of viral infection, the AUC was 0.93 for mRNA and 0.84 for the protein panel (p<0.05). This corresponded to a sensitivity and specificity of 89% and 82% for the mRNA panel, and 85% and 62% for the protein panel, respectively.CONCLUSIONS:
A gene expression signature was the most accurate host response strategy for classifying subjects with bacterial, viral, or non-infectious ARI.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções Respiratórias
/
Bactérias
/
Infecções Bacterianas
/
Vírus
/
Viroses
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article