A comparison of host response strategies to distinguish bacterial and viral infection.
Journal Article (Journal Article)
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.
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Duke Authors
- Ginsburg, Geoffrey Steven
- Henao, Ricardo
- McClain, Micah Thomas
- Tsalik, Ephraim
- Woods, Christopher Wildrick
Cited Authors
- Ross, M; Henao, R; Burke, TW; Ko, ER; McClain, MT; Ginsburg, GS; Woods, CW; Tsalik, EL
Published Date
- 2021
Published In
Volume / Issue
- 16 / 12
Start / End Page
- e0261385 -
PubMed ID
- 34905580
Pubmed Central ID
- PMC8670660
Electronic International Standard Serial Number (EISSN)
- 1932-6203
Digital Object Identifier (DOI)
- 10.1371/journal.pone.0261385
Language
- eng
Conference Location
- United States