Host transcriptional signatures predict etiology in community-acquired pneumonia: Potential antibiotic stewardship tools
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Host transcriptional signatures predict etiology in community-acquired pneumonia: Potential antibiotic stewardship tools. / Siljan, William W; Sivakumaran, Dhanasekaran; Ritz, Christian; Jenum, Synne; Ottenhoff, Tom Hm; Ulvestad, Elling; Holter, Jan C; Heggelund, Lars; Grewal, Harleen MS.
In: Biomarker Insights, Vol. 17, No. January-December, 2022, p. 1-8.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Host transcriptional signatures predict etiology in community-acquired pneumonia: Potential antibiotic stewardship tools
AU - Siljan, William W
AU - Sivakumaran, Dhanasekaran
AU - Ritz, Christian
AU - Jenum, Synne
AU - Ottenhoff, Tom Hm
AU - Ulvestad, Elling
AU - Holter, Jan C
AU - Heggelund, Lars
AU - Grewal, Harleen MS
N1 - © The Author(s) 2022.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Faculty of Science
KW - Pneumonia
KW - Gene expression signatures
KW - Bacteria
KW - Viruses
KW - Antimicrobial stewardship
KW - Clinical decision-making
U2 - 10.1177/11772719221099130
DO - 10.1177/11772719221099130
M3 - Journal article
C2 - 35693251
VL - 17
SP - 1
EP - 8
JO - Biomarker Insights
JF - Biomarker Insights
SN - 1177-2719
IS - January-December
ER -
ID: 310222190