A novel host-protein assay outperforms routine parameters for distinguishing between bacterial and viral lower respiratory tract infections
Bacterial and viral lower respiratory tract infections (LRTIs) are often clinically indistinguishable, leading to antibiotic overuse. We compared the diagnostic accuracy of a new assay that combines 3 host-biomarkers (TRAIL, IP-10, CRP) with parameters in routine use to distinguish bacterial from vi...
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| Veröffentlicht in: | Diagnostic microbiology and infectious disease 2018-03, Vol.90 (3), p.206-213 |
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| creator | Stein, Michal Lipman-Arens, Shelly Oved, Kfir Cohen, Asi Bamberger, Ellen Navon, Roy Boico, Olga Friedman, Tom Etshtein, Liat Paz, Meital Gottlieb, Tanya M. Kriger, Or Fonar, Yura Pri-Or, Ester Yacobov, Renata Dotan, Yaniv Hochberg, Amit Grupper, Moti Chistyakov, Irina Potasman, Israel Srugo, Isaac Eden, Eran Klein, Adi |
| description | Bacterial and viral lower respiratory tract infections (LRTIs) are often clinically indistinguishable, leading to antibiotic overuse. We compared the diagnostic accuracy of a new assay that combines 3 host-biomarkers (TRAIL, IP-10, CRP) with parameters in routine use to distinguish bacterial from viral LRTIs. Study cohort included 184 potentially eligible pediatric and adult patients. Reference standard diagnosis was based on adjudication by an expert panel following comprehensive clinical and laboratory investigation (including respiratory PCRs). Experts were blinded to assay results and assay performers were blinded to reference standard outcomes. Evaluated cohort included 88 bacterial and 36 viral patients (23 did not fulfill inclusion criteria; 37 had indeterminate reference standard outcome). Assay distinguished bacterial from viral LRTI patients with sensitivity of 0.93±0.06 and specificity of 0.91±0.09, outperforming routine parameters, including WBC, CRP and chest x-ray signs. These findings support the assay's potential to help clinicians avoid missing bacterial LRTIs or overusing antibiotics. |
| doi_str_mv | 10.1016/j.diagmicrobio.2017.11.011 |
| format | Article |
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These findings support the assay's potential to help clinicians avoid missing bacterial LRTIs or overusing antibiotics.</description><subject>Antibiotics</subject><subject>Biomarkers</subject><subject>Diagnostics</subject><subject>Host-immune response</subject><subject>LRTI</subject><subject>Pneumonia</subject><issn>0732-8893</issn><issn>1879-0070</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqNkc1u1TAQhS1ERS-FV0AWKzYJtvNjm11VWkCq1A2sLceetL5K4uBxbnWfgZfG1S2IJavx2N94dM4h5D1nNWe8_7ivfbD3c3ApDiHWgnFZc14zzl-QHVdSV4xJ9pLsmGxEpZRuzslrxD1jXOiWvSLnQgvZtErsyK9LusQDTPQhYq7WFDOEhVpEe6RxyyukMaYZaSpNWICuNtkZMiSk5YH6gOX6fgv4UAodID8CLHSwriDBTtQunh5CKqcpPkKiCXAtbY7pSHMqGA3LCC6HuOAbcjbaCeHtc70gP26uv199rW7vvny7urytXKNYrnzre229ZhoAnBds8Mp720HXS6eK8sZK3rc916ob5Ni6xnbKN9r1tutHwZoL8uH0b5H7cwPMZg7oYJrsAnFDw7XUuheCdQX9dEKL14gJRrOmMNt0NJyZpzDM3vwbhnkKw3BuShhl-N3znm2Ywf8d_eN-AT6fAChqDwGSQRdgceBDKp4YH8P_7PkNQFqmyA</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Stein, Michal</creator><creator>Lipman-Arens, Shelly</creator><creator>Oved, Kfir</creator><creator>Cohen, Asi</creator><creator>Bamberger, Ellen</creator><creator>Navon, Roy</creator><creator>Boico, Olga</creator><creator>Friedman, Tom</creator><creator>Etshtein, Liat</creator><creator>Paz, Meital</creator><creator>Gottlieb, Tanya M.</creator><creator>Kriger, Or</creator><creator>Fonar, Yura</creator><creator>Pri-Or, Ester</creator><creator>Yacobov, Renata</creator><creator>Dotan, Yaniv</creator><creator>Hochberg, Amit</creator><creator>Grupper, Moti</creator><creator>Chistyakov, Irina</creator><creator>Potasman, Israel</creator><creator>Srugo, Isaac</creator><creator>Eden, Eran</creator><creator>Klein, Adi</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180301</creationdate><title>A novel host-protein assay outperforms routine parameters for distinguishing between bacterial and viral lower respiratory tract infections</title><author>Stein, Michal ; 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| ispartof | Diagnostic microbiology and infectious disease, 2018-03, Vol.90 (3), p.206-213 |
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| language | eng |
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| source | Access via ScienceDirect (Elsevier) |
| subjects | Antibiotics Biomarkers Diagnostics Host-immune response LRTI Pneumonia |
| title | A novel host-protein assay outperforms routine parameters for distinguishing between bacterial and viral lower respiratory tract infections |
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