ArticlePloS one2021
A comparison of host response strategies to distinguish bacterial and viral infection.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of MMBV in predicting bacterial infection in febrile children: a systematic review and meta-analysis.Italian journal of pediatrics · 2026Pooled it
- Trial
- BCG overexpressing Ag85B reprograms host immune response through coordinated transcriptional networks.Frontiers in immunology · 2026Article
- A four-gene signature from blood to exclude bacterial etiology of lower respiratory tract infection in adults.Nature communications · 2025Article
- A Four-Gene Signature from Blood to Exclude Bacterial Etiology of Lower Respiratory Tract Infection in Adults.Research square · 2025Article
- Reassessing sepsis research: new clues for old players and new players for an old symptom to improve patient outcomes.EXCLI journal · 2025Review
- Clinical application of Myxovirus resistance protein A as a diagnostic biomarker to differentiate viral and bacterial respiratory infections in pediatric patients.Frontiers in immunology · 2025Article
- Evaluation of the Diversities in the Inflammatory Responses in Cats With Bacterial and Viral Infections.Veterinary medicine and science · 2024Article
- The mammosphere-derived epithelial cell secretome modulates neutrophil functions in the bovine model.Frontiers in immunology · 2024Article
- Prognosis and prediction of antibiotic benefit in adults with clinically diagnosed acute rhinosinusitis: an individual participant data meta-analysis.Diagnostic and prognostic research · 2023Article
- Prospective Validation of a Rapid Host Gene Expression Test to Discriminate Bacterial From Viral Respiratory Infection.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesCompare three host response strategies to distinguish bacterial and viral etiologies of acute respiratory illness (ARI).
methodsIn 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.
resultsThe 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.
conclusionsA gene expression signature was the most accurate host response strategy for classifying subjects with bacterial, viral, or non-infectious ARI.
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