Observational studyJAMA
Association of RNA Biosignatures With Bacterial Infections in Febrile Infants Aged 60 Days or Younger.
Observational study in JAMA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 109 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
109 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Molecular assays for the diagnosis of sepsis in neonates: a diagnostic test accuracy review.The Cochrane database of systematic reviews · 2025Pooled it
- Transcript host-RNA signatures to discriminate bacterial and viral infections in febrile children.Pediatric research · 2022Pooled it
- Prevalence of Bacterial Meningitis Among Febrile Infants Aged 29-60 Days With Positive Urinalysis Results: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Gene expression profiling reveals insights into infant immunological and febrile responses to group B meningococcal vaccine.Molecular systems biology · 2020Trial
- The Feasibility of Host Transcriptome Profiling as a Diagnostic Tool for Microbial Etiology in Childhood Cancer Patients with Febrile Neutropenia.International journal of molecular sciences · 2020Trial
- Exploratory study on blood and urine transcriptomes for identifying miRNA biomarkers in pediatric febrile bacterial and viral infections.Scientific reports · 2026Article
- Host gene expression analysis in the detection of bacterial and viral etiology in children hospitalized with a suspected severe infection.Communications medicine · 2026Article
- Early diagnosis of serious bacterial infection in febrile infants using type I interferon signature.Pediatric research · 2026Article
- Diagnostic tests for urinary tract infections and antimicrobial resistance-a reality check between diagnostic innovation and implementation: a critical narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections.Pediatrics · 2025Article
- Direct single cell-type gene expression analysis in peripheral blood: novel ratio-based gene expression biomarkers using 2 novel monocyte reference genes (PSAP and CTSS) for detection of bacterial infection.Human molecular genetics · 2025Article
- Article
- Fever in Children with Cancer: Pathophysiological Insights Using Blood Transcriptomics.International journal of molecular sciences · 2025Article
- Risk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses.Pediatrics · 2025Article
- Risk Factors for Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol for a Multicenter, Retrospective Case-Control Study.JMIR research protocols · 2025Article
- Metagenomic signatures of extraintestinal bacterial infection in the febrile term infant gut microbiome.Microbiome · 2025Article
- A rapid host-protein test for differentiating bacterial from viral infection: Apollo diagnostic accuracy study.Journal of the American College of Emergency Physicians open · 2024Article
- Host RNA Expression Signatures in Young Infants with Urinary Tract Infection: A Prospective Study.International journal of molecular sciences · 2024Article
- Risk of serious bacterial infections in pediatric patients with hyperpyrexia.Journal of the American College of Emergency Physicians open · 2024Article
- Adoption of C-reactive protein rapid tests for the management of acute childhood infections in hospitals in the Netherlands and England: a comparative health systems analysis.BMC health services research · 2024Article
49 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
40 authors.
Funding
Abstract
importanceYoung febrile infants are at substantial risk of serious bacterial infections; however, the current culture-based diagnosis has limitations. Analysis of host expression patterns ("RNA biosignatures") in response to infections may provide an alternative diagnostic approach.
objectiveTo assess whether RNA biosignatures can distinguish febrile infants aged 60 days or younger with and without serious bacterial infections. DESIGN, SETTING, AND
participantsProspective observational study involving a convenience sample of febrile infants 60 days or younger evaluated for fever (temperature >38° C) in 22 emergency departments from December 2008 to December 2010 who underwent laboratory evaluations including blood cultures. A random sample of infants with and without bacterial infections was selected for RNA biosignature analysis. Afebrile healthy infants served as controls. Blood samples were collected for cultures and RNA biosignatures. Bioinformatics tools were applied to define RNA biosignatures to classify febrile infants by infection type. EXPOSURE: RNA biosignatures compared with cultures for discriminating febrile infants with and without bacterial infections and infants with bacteremia from those without bacterial infections. MAIN OUTCOMES AND MEASURES: Bacterial infection confirmed by culture. Performance of RNA biosignatures was compared with routine laboratory screening tests and Yale Observation Scale (YOS) scores.
resultsOf 1883 febrile infants (median age, 37 days; 55.7% boys), RNA biosignatures were measured in 279 randomly selected infants (89 with bacterial infections-including 32 with bacteremia and 15 with urinary tract infections-and 190 without bacterial infections), and 19 afebrile healthy infants. Sixty-six classifier genes were identified that distinguished infants with and without bacterial infections in the test set with 87% (95% CI, 73%-95%) sensitivity and 89% (95% CI, 81%-93%) specificity. Ten classifier genes distinguished infants with bacteremia from those without bacterial infections in the test set with 94% (95% CI, 70%-100%) sensitivity and 95% (95% CI, 88%-98%) specificity. The incremental C statistic for the RNA biosignatures over the YOS score was 0.37 (95% CI, 0.30-0.43). CONCLUSIONS AND RELEVANCE: In this preliminary study, RNA biosignatures were defined to distinguish febrile infants aged 60 days or younger with vs without bacterial infections. Further research with larger populations is needed to refine and validate the estimates of test accuracy and to assess the clinical utility of RNA biosignatures in practice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.