A comparison of host response strategies to distinguish bacterial and viral infection

Compare three host response strategies to distinguish bacterial and viral etiologies of acute respiratory illness (ARI). 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 em...

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Veröffentlicht in:	PloS one 2021-12, Vol.16 (12), p.e0261385-e0261385
Hauptverfasser:	Ross, Melissa, Henao, Ricardo, Burke, Thomas W, Ko, Emily R, McClain, Micah T, Ginsburg, Geoffrey S, Woods, Christopher W, Tsalik, Ephraim L
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Analysis Antibiotics Bacteria Bacteria - isolation & purification Bacterial diseases Bacterial infections Bacterial Infections - complications Bacterial Infections - diagnosis Bacterial Infections - metabolism Bacterial Infections - microbiology Biology and Life Sciences Biomarkers Biomarkers - metabolism C-Reactive Protein - genetics C-Reactive Protein - metabolism Case-Control Studies Chemokine CXCL10 - genetics Chemokine CXCL10 - metabolism Diagnosis, Differential Emergency medical care Emergency Service, Hospital Enrollments Etiology Female Follow-Up Studies Gene expression Genomics Hospitals Host-bacteria relationships Humans Illnesses Immunoassay Infection Infections IP-10 protein Laboratories Male Medical diagnosis Medicine and Health Sciences Middle Aged Pathogens Pneumonia Precision medicine Procalcitonin Procalcitonin - genetics Procalcitonin - metabolism Prognosis Proteins Receptors, Immunologic - genetics Receptors, Immunologic - metabolism Respiratory diseases Respiratory Tract Infections - epidemiology Respiratory Tract Infections - etiology Respiratory Tract Infections - metabolism Respiratory Tract Infections - pathology Retrospective Studies ROC Curve Sensitivity Sepsis TNF-Related Apoptosis-Inducing Ligand - genetics TNF-Related Apoptosis-Inducing Ligand - metabolism United States - epidemiology Veterans Viral infections Virus Diseases - complications Virus Diseases - diagnosis Virus Diseases - virology Viruses - isolation & purification
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Zusammenfassung:	Compare three host response strategies to distinguish bacterial and viral etiologies of acute respiratory illness (ARI). 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. 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
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0261385