期刊
BIOMARKER INSIGHTS
卷 17, 期 -, 页码 -出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/11772719221099130
关键词
Pneumonia; gene expression signatures; bacteria; viruses; antimicrobial stewardship; clinical decision-making
资金
- Research Council of Norway (NORCAP) [288718]
- University of Bergen
- Haukeland University Hospital
- Vestre Viken Hospital Trust, Norway
This study suggests that detecting host transcriptional signatures in peripheral blood samples may serve as a potential tool for guiding clinical decision-making and antibiotic stewardship in community-acquired pneumonia (CAP).
BACKGROUND: Current approaches for pathogen identification in community-acquired pneumonia (CAP) remain suboptimal, leaving most patients without a microbiological diagnosis. If better diagnostic tools were available for differentiating between viral and bacterial CAP. unnecessary antibacterial therapy could be avoided in viral CAP patients. METHODS: In 156 adults hospitalized with CAP classified to have bacterial. viral, or mixed viral-bacterial infection based on microbiological testing or both microbiological testing and procalcitonin (PCT) levels, we aimed to identify discriminatory host transcriptional signatures in peripheral blood samples acquired at hospital admission, by applying Dual-color-Reverse-Transcriptase-Multiplex-Ligation-dependent-Probe-Amplification (dc-RT MLPA). RESULTS: In patients classified by microbiological testing, a 9-transcript signature showed high accuracy for discriminating bacterial from viral CAP (AUC 0.91. 95% CI 0.85-0.96). while a 10-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.91, 95% CI 0.86-0.96). In patients classified by both microbiological testing and PCT levels, a 13-transcript signature showed excellent accuracy for discriminating bacterial from viral CAP (AUC 1.00, 95% CI 1.00-1.00), while a 7-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.93, 95% CI 0.87-0.98). CONCLUSION: Our findings support host transcriptional signatures in peripheral blood samples as a potential tool for guiding clinical decision-making and antibiotic stewardship in CAP.
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