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 |
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| creator | Ross, Melissa Henao, Ricardo Burke, Thomas W Ko, Emily R McClain, Micah T Ginsburg, Geoffrey S Woods, Christopher W Tsalik, Ephraim L |
| description | 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 |
| doi_str_mv | 10.1371/journal.pone.0261385 |
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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<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.
A gene expression signature was the most accurate host response strategy for classifying subjects with bacterial, viral, or non-infectious ARI.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0261385</identifier><identifier>PMID: 34905580</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2021-12, Vol.16 (12), p.e0261385-e0261385</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-1db50eeb753f0064f58886fe4f63a9dd2e566bf766c34c5a065893d1f14d7b6e3</citedby><cites>FETCH-LOGICAL-c692t-1db50eeb753f0064f58886fe4f63a9dd2e566bf766c34c5a065893d1f14d7b6e3</cites><orcidid>0000-0003-4980-845X ; 0000-0002-6417-2042 ; 0000-0003-0592-5822</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670660/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670660/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34905580$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Moreira, José</contributor><creatorcontrib>Ross, Melissa</creatorcontrib><creatorcontrib>Henao, Ricardo</creatorcontrib><creatorcontrib>Burke, Thomas W</creatorcontrib><creatorcontrib>Ko, Emily R</creatorcontrib><creatorcontrib>McClain, Micah T</creatorcontrib><creatorcontrib>Ginsburg, Geoffrey S</creatorcontrib><creatorcontrib>Woods, Christopher W</creatorcontrib><creatorcontrib>Tsalik, Ephraim L</creatorcontrib><title>A comparison of host response strategies to distinguish bacterial and viral infection</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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<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.
A gene expression signature was the most accurate host response strategy for classifying subjects with bacterial, viral, or non-infectious ARI.</description><subject>Adult</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Bacteria - isolation & purification</subject><subject>Bacterial diseases</subject><subject>Bacterial infections</subject><subject>Bacterial Infections - complications</subject><subject>Bacterial Infections - diagnosis</subject><subject>Bacterial Infections - metabolism</subject><subject>Bacterial Infections - microbiology</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>C-Reactive Protein - genetics</subject><subject>C-Reactive Protein - metabolism</subject><subject>Case-Control Studies</subject><subject>Chemokine CXCL10 - genetics</subject><subject>Chemokine CXCL10 - metabolism</subject><subject>Diagnosis, Differential</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital</subject><subject>Enrollments</subject><subject>Etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gene expression</subject><subject>Genomics</subject><subject>Hospitals</subject><subject>Host-bacteria relationships</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Immunoassay</subject><subject>Infection</subject><subject>Infections</subject><subject>IP-10 protein</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Pathogens</subject><subject>Pneumonia</subject><subject>Precision medicine</subject><subject>Procalcitonin</subject><subject>Procalcitonin - genetics</subject><subject>Procalcitonin - metabolism</subject><subject>Prognosis</subject><subject>Proteins</subject><subject>Receptors, Immunologic - genetics</subject><subject>Receptors, Immunologic - metabolism</subject><subject>Respiratory diseases</subject><subject>Respiratory Tract Infections - epidemiology</subject><subject>Respiratory Tract Infections - etiology</subject><subject>Respiratory Tract Infections - metabolism</subject><subject>Respiratory Tract Infections - pathology</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity</subject><subject>Sepsis</subject><subject>TNF-Related Apoptosis-Inducing Ligand - genetics</subject><subject>TNF-Related Apoptosis-Inducing Ligand - metabolism</subject><subject>United States - epidemiology</subject><subject>Veterans</subject><subject>Viral infections</subject><subject>Virus Diseases - complications</subject><subject>Virus Diseases - diagnosis</subject><subject>Virus Diseases - virology</subject><subject>Viruses - 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isolation & purification</topic><topic>Bacterial diseases</topic><topic>Bacterial infections</topic><topic>Bacterial Infections - complications</topic><topic>Bacterial Infections - diagnosis</topic><topic>Bacterial Infections - metabolism</topic><topic>Bacterial Infections - microbiology</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers</topic><topic>Biomarkers - metabolism</topic><topic>C-Reactive Protein - genetics</topic><topic>C-Reactive Protein - metabolism</topic><topic>Case-Control Studies</topic><topic>Chemokine CXCL10 - genetics</topic><topic>Chemokine CXCL10 - metabolism</topic><topic>Diagnosis, Differential</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital</topic><topic>Enrollments</topic><topic>Etiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gene expression</topic><topic>Genomics</topic><topic>Hospitals</topic><topic>Host-bacteria relationships</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Immunoassay</topic><topic>Infection</topic><topic>Infections</topic><topic>IP-10 protein</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Pathogens</topic><topic>Pneumonia</topic><topic>Precision medicine</topic><topic>Procalcitonin</topic><topic>Procalcitonin - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ross, Melissa</au><au>Henao, Ricardo</au><au>Burke, Thomas W</au><au>Ko, Emily R</au><au>McClain, Micah T</au><au>Ginsburg, Geoffrey S</au><au>Woods, Christopher W</au><au>Tsalik, Ephraim L</au><au>Moreira, José</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of host response strategies to distinguish bacterial and viral infection</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-12-14</date><risdate>2021</risdate><volume>16</volume><issue>12</issue><spage>e0261385</spage><epage>e0261385</epage><pages>e0261385-e0261385</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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<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.
A gene expression signature was the most accurate host response strategy for classifying subjects with bacterial, viral, or non-infectious ARI.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34905580</pmid><doi>10.1371/journal.pone.0261385</doi><tpages>e0261385</tpages><orcidid>https://orcid.org/0000-0003-4980-845X</orcidid><orcidid>https://orcid.org/0000-0002-6417-2042</orcidid><orcidid>https://orcid.org/0000-0003-0592-5822</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2610042845 |
| source | MEDLINE; PMC (PubMed Central); DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; Free Full-Text Journals in Chemistry |
| subjects | 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 |
| title | A comparison of host response strategies to distinguish bacterial and viral infection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T04%3A18%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20comparison%20of%20host%20response%20strategies%20to%20distinguish%20bacterial%20and%20viral%20infection&rft.jtitle=PloS%20one&rft.au=Ross,%20Melissa&rft.date=2021-12-14&rft.volume=16&rft.issue=12&rft.spage=e0261385&rft.epage=e0261385&rft.pages=e0261385-e0261385&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0261385&rft_dat=%3Cgale_plos_%3EA686741216%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2610042845&rft_id=info:pmid/34905580&rft_galeid=A686741216&rft_doaj_id=oai_doaj_org_article_460e9de96bd54063a3bd7f1083f3fd29&rfr_iscdi=true |